Diabetes increases the risk of developing gangrene, as it leads to damage to both sensory and motor nerves, resulting in the patient losing sensation in their feet. This means the patient may not feel injuries or wounds on their feet, making them more vulnerable to contamination and bacterial spread.
Moreover, diabetes affects the function of blood vessels, reducing the supply of blood carrying the necessary nutrients and oxygen to nourish cells and the immune system in the feet. This slows down the healing process of wounds affecting the feet.
Gangrene occurs when blood supply to a part of the body is cut off, resulting in tissue death. Gangrene typically starts in the toes or feet. Gangrene can occur due to a severe injury such as a deep wound or severe burn, or as a result of an infection or a medical condition that affects the blood circulation and blood flow, increasing the risk of gangrene.
Certain groups of people are more susceptible to the risk of gangrene, especially those with long-term conditions that can affect their blood vessels, such as the following diseases:
It is a chronic disease that remains lifelong, causing the person’s blood sugar level to be very high.
These include arteriosclerosis, which is a condition of artery blockage due to the accumulation of fatty substances and cholesterol on the blood vessel wall, narrowing and restricting blood flow.
It is an abnormal vascular reaction to cold temperatures and psychological stress in certain parts of the body, usually in the toes, where small arteries narrow and obstruct blood flow to the extremities.
This is the most common type among diabetic patients and immune disorders. It appears in the extremities, starting with a red color and turning black.
It occurs as a result of infection in wounds and ulcers simultaneously with poor blood flow to the affected area, leading to tissue death. This makes the area swollen, filled with fluids and pus, and emits a foul odor. It can also spread to other parts of the body.
Gangrene is a medical emergency. The severity of gangrene depends on the location and size of the affected area, as well as any other underlying conditions the patient may have. Gangrene is often life-threatening, so immediate medical care is crucial. It’s essential to visit the best vascular surgeon, Dr. Hossam El Mahdy, a professor of vascular surgery and diabetic foot treatment at Cairo University, when the following symptoms appear:
Dr. Hossam El Mahdy determines the best treatment plan for the patient based on their age, overall health, medical history, disease severity, and the expected progression of the condition. The treatment plan for gangrene typically involves implementing one or more of the following procedures:
Antibiotic therapy: These medications are used to kill bacteria in the affected area, so they are typically utilized in cases of moist gangrene.
Surgical debridement: This procedure aims to prevent the spread of gangrene to nearby healthy tissues. Skin grafting may be advised to create a conducive environment for wound healing. In cases where gangrene has spread extensively, amputation of the affected toe or limb may be necessary.
Hyperbaric oxygen therapy: During this procedure, the patient is placed in a specially equipped chamber with high-pressure oxygen, which delivers more oxygen to the affected area. This can promote rapid healing and help kill bacteria. This treatment is particularly effective for individuals who develop gangrene from diabetic foot ulcers.
Therapeutic peripheral angiography: If gangrene is caused by impaired blood flow, therapeutic peripheral angiography may be recommended to improve blood circulation.
When seeking treatment from a vascular surgeon at the onset of gangrene, it may be possible to treat the condition without resorting to amputation by addressing the underlying circulatory insufficiency causing impaired blood flow.
Therapeutic peripheral angiography involves dilating blocked or narrowed arteries using a therapeutic balloon, with the placement of a stent if necessary, in addition to cleaning already damaged tissues.
You can help prevent gangrene by following these steps:
