An elderly person with occlusive arterial disease presents with shriveled skin over the affected part. This part is brown or black in colour and gives a foul smelling odour. The condition is DRY GANGRENE.
Dry gangrene develops because of gradual deprivation of arterial blood supply. Although there is arterial occulusion the venous supply remains unimpeded. There is a definite bright red line of demarcation that appears between the living and the dead tissue. This dry gangrene is mostly seen in senile diabetics, buerger’s disease, raynaud’s disease, embolism, ligation, injury to a vessel, frostbite, oracid or alkali burns.
When gangrene affects skin, signs and symptoms may include:
Wet gangrene. Gangrene is referred to as "wet" if there's a bacterial infection in the affected tissue. Swelling, blistering and a wet appearance are common features of wet gangrene.
It may develop after a severe burn, frostbite or injury. It often occurs in people with diabetes who unknowingly injure a toe or foot. Wet gangrene needs to be treated immediately because it spreads quickly and can be fatal.
Gas gangrene. Gas gangrene typically affects deep muscle tissue. If you have gas gangrene, the surface of your skin may initially appear normal.
As the condition progresses, your skin may become pale and then evolve to a gray or purplish red color. A bubbly appearance to your skin may become apparent, and the affected skin may make a crackling sound when you press on it because of the gas within the tissue.
Gas gangrene is most commonly caused by infection with the bacterium Clostridium perfringens, which develops in an injury or surgical wound that's depleted of blood supply. The bacterial infection produces toxins that release gas — hence the name "gas" gangrene — and cause tissue death. Like wet gangrene, gas gangrene can be life-threatening.
Internal gangrene. Gangrene that affects one or more of your organs, such as your intestines, gallbladder or appendix, is called internal gangrene. This type of gangrene occurs when blood flow to an internal organ is blocked — for example, when your intestines bulge through a weakened area of muscle in your abdomen (hernia) and become twisted.
Internal gangrene may cause fever and severe pain. Left untreated, internal gangrene can be fatal.
Several factors increase your risk of developing gangrene. These include:
Gangrene can lead to scarring or the need for reconstructive surgery. Sometimes, the amount of tissue death is so extensive that a body part, such as your foot, may need to be removed (amputated).
Gangrene that is infected with bacteria can spread quickly to other organs and may be fatal if left untreated.
Here are a few suggestions to help you reduce your risk of developing gangrene:
The patient should receive general treatment such as a nutrition diet, control of blood sugar, relief from pain and care of the heart.
The affected part should be kept dry. Keep the part elevated to reduce pain. Do not apply any hot fomentation or warmth over the affected area, protect the part from local pressure. Keep the wound clean by removing the slough and paring the nails.
Secale cornutum is ergot of rye, a fungus. It contracts the muscles of the blood is very thin, foetid, watery and black, oozing continuosly. The skin gets shriveled, numb, mottled and dusky with a blue tinge. Dry gangrene develops slowly, with bloody blisters. The varicose ulcers are foul and indolent with a burning sensation that is better by cold. Patient wants parts uncovered, although the skin is cold to touch. Pains are neuralgic and sharp, burning like fire. Great restlessness, great debility and prostration to the point of collapse.
Anthracinum is anthrax nosode and is very valueable in the treatment of malignant disease or septic inflammations of connective or cellular tissues. It produces boils, malignant ulcers, abscesses and buboes, where there is a purulent focus. Great restlessness with debility, depression and pain in limbs. General sense of malaise and terrible burning pains.
Arsenicum album is a deep acting remedy affecting every organ and tissue. It produces inveterate neuralgias and multiple neuritis. Great anxiety, exhaustion and restlessness, with nocturnal aggravation; better by heart. The skin is dry, shriveled, like parchment. Eruptions are dry, rough, scaly and worse cold.
Phosphorus is a remedy of haemorrhagic diathesis as blood looses its coagulability. The pains, in general are burning in character and the patient has marked thirst for cold water. The ulcers bleed easily on slightest touch. The large ulcers are surrounded by smaller ones. Burning of skin with restlessness.
Lachesis mutus has a bluish-purple appearance of boils and ulcers; dark blister with black edges. Small wounds bleed easily. Capillaries are dilated.