SCRIPT NUMBER 98
GANGRENE
(TWO SPEAKERS)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: 98
PROGRAM NUMBER: GANGRENE
SUBJECT: SYMPTOMS, CAUSES, COMPLICATIONS, TREATMENT,
PREVENTION OF GANGRENE
KEY WORDS: OOZE, NUTRITION, SKIN GRAFT, NICOTINE, FROSTBITE,
SURGICAL REMOVAL, EXPOSED SKIN
DATE OF SCRIPT: FEBRUARY 8, 2013
AUTHOR: RICHARD YUKL, MD, FACS
SPEAKER 1:
John lives in a country where the economy is poor, jobs are
scarce, and everyone worries about being able to have enough food to feed their
family. When a new road was being built through his area, John applied for a job
as a construction worker. The construction jobs paid very well. To his delight, he
was hired to operate a paving machine, a heavy machine that receives and
spreads concrete from cement trucks, making a single lane of highway surface.
One day a portion of the delivery boom on his machine became stuck, and as he
tried to loosen it, a piece of steel fell onto his left hand, causing a small cut on the
hand as well as a large amount of swelling and pain. He didn’t go to see a doctor.
He is diabetic, so he has to see a doctor often, and he doesn’t like doing it. After
several days, John noticed that, although his hand had been red and bruised at
first, it was slowly changing to a dark brownish color. It was becoming cold to the
touch and beginning to feel numb. Later, some skin of his injured hand became
black and started to drain a bad-smelling ooze. Alarmed, he finally went to see
his doctor only to find, to his sorrow, that gangrene had developed in his injured
hand. His doctor told him that people with diabetes are at increased risk of
developing gangrene after trauma.
SPEAKER 2:
Today, we want to talk about gangrene. The word refers to
the death of some of your body’s tissues because of a lack of blood and
nourishment flowing to those tissues, or because of an infection. Gangrene most
commonly occurs in the legs and arms, but it can also develop in muscles or in
internal organs. Your blood provides oxygen and nourishment to the cells of your
body, and without that constant support, the cells die from starvation and begin to
decay.
SPEAKER 1:
What are the risk factors for developing gangrene?
SPEAKER 2:
One factor is age. Gangrene occurs far more often in older
people. Another factor is diabetes. If you have diabetes, your body doesn’t
produce enough insulin for its needs. As you eat and digest food, the sugar from
that food enters your bloodstream, but without insulin, it is unable to enter your
cells to nourish them. Diabetes that isn’t properly controlled also causes your
blood vessels to harden and narrow with time, lowering blood flow.
John had a severe injury to his hand, and trauma is yet another factor for
developing gangrene, especially if you have an underlying medical condition that
may already be lowering your blood flow – in his case diabetes.
SPEAKER 1:
Life is full of accidents that cause trauma to some part of my
body nearly every day. Just when should I become concerned enough about a
bump or a bruise to see a doctor?
SPEAKER 2:
Get help if the injured area becomes pale in color, or if it
begins to turn blue or black. Also, be concerned if a wound doesn’t heal in 1-2
weeks, or if pain in the wound begins to increase. It is essential to see a doctor if
the injured area begins to develop a foul-smelling odor, or if pus begins to drain
from the area. Your doctor has access to the tests needed to diagnose gangrene,
and he can start you on the proper antibiotics if an infection has begun.
SPEAKER 1:
How should gangrene be treated?
SPEAKER 2:
Gangrene is a life-threatening condition. Tissues that have
already developed gangrene cannot be saved, but steps can be taken to prevent
the gangrene from spreading. You must take appropriate antibiotics if an
infection has begun. Your doctor may need to remove dead tissues to allow
injured tissues to heal. Your doctor may even need to repair damaged or
diseased blood vessels to increase blood flow to the involved area. A skin graft
may be needed to replace skin that gangrene has destroyed. Healthy skin is
taken from a part of your body that is normally hidden by clothing and carefully
spread over the area where skin has been lost, being held in place by bandages
or by several small stitches. In severe cases of gangrene, an affected body part
such as a toe, finger or even an arm or leg may need to be surgically removed to
save your life.
SPEAKER 1:
John’s doctor was able to cut away gangrene from the back
of his hand and start him on appropriate antibiotics, saving his hand. The hand
might have required surgical removal had John waited longer to begin treatment.
Tell me some ways I can reduce my risk of developing gangrene.
SPEAKER 2:
If you find any open wounds, wash them with a mild soap
and water at least twice a day, keeping them clean and dry until they heal. If you
are overweight, get back to a normal weight. Extra pounds not only put you at
risk of diabetes, but they also place pressure on your arteries, narrowing them
and lowering blood flow. If you have diabetes, make sure you examine your
hands and feet every day for cuts, sores and signs of infection such as redness,
swelling or drainage. If you smoke tobacco, quit. The nicotine in tobacco does
actual damage to your blood vessels, slowing blood flow.
Finally, be extra careful in cold weather. Cold air can cause frostbite, a condition
where exposed areas of your skin actually freeze. Frostbite is another form of
gangrene, and it most commonly damages areas such as your fingers and toes.
Guard against leaving any area of your skin exposed if you are in cold weather.
SPEAKER 1:
Health Nuggets is written by Dr. Richard Yukl, a medical
doctor working in the United States. The medical views expressed in this
program are his and may differ for your particular health needs. If you need
medical advice, please consult a medical professional in your area.