What is gangrene?
Gangrene is a potentially fatal disorder that manifests itself when a part of the body is cut off from its blood supply and nutrients, leading to the breakdown and death of the tissue in that region. Gangrene causes the skin to turn a colour between green and black, and it can also cause damage to internal organs. However, it most frequently begins in the digits of the hands, feet, and fingers. If gangrene therapy is started sooner rather than later, there is a better chance of success! If treatment is not received, gangrene can cause excruciating agony, may result in amputation, and may even be deadly.
How is gangrene related to diabetic foot?
The most severe complications of diabetes include diabetic foot and gangrene, which, if left untreated, can lead to amputations or even death.
In the diabetic foot, smaller unidentified arteries may operate as ‘end-arteries’ due to numerous atherosclerotic plaques that either completely block or partially restrict blood flow. In the case of localized necrosis of the tip of a toe, the excision of the gangrenous tissue, in conjunction with aggressive treatment of the infection, may lead to healing if the tiny arteries are still patent. Transluminal angioplasty or stenting of the occluded arteries will make it possible to treat the foot with the appropriate antibiotics and save it.
At the same time, a gangrenous toe can be isolated by mummification (dry gangrene) without causing any severe complications. Gangrene of the fifth toe, or the hallux, is caused by atherosclerotic disease that has progressed further and will most likely result in the toe’s amputation or the joint’s disarticulation.
Elements that help make up the whole diabetes foot and gangrene have several other risk factors, including improper foot cleanliness, foot trauma or injury, and poor nutrition. Diabetes must be effectively treated, and preventative steps must be taken to reduce the likelihood of complications involving the feet.
Signs of gangrene in diabetic patients?
The following are some of the common symptoms of gangrene:
● A reddish colouration in the affected area, which may later turn brown or even black.
● The agony is replaced by numbness.
Also there are two types of gangrene in diabetic patients i.e. dry and wet, which are explained below:
Dry gangrene and diabetes
Dry gangrene is a type of gangrene that can develop as a complication of an existing health condition, such as type 1 or type 2 diabetes. If hyperglycemia persists for an extended period, the blood vessels throughout the body may become damaged and disrupt blood circulation. Because blood provides oxygen and nutrients to the tissue around the body, the tissue will eventually perish if the body does not have enough blood. This condition typically manifests itself initially in the extremities, specifically the toes, foot, and fingers.
Wet gangrene and diabetes
Wet gangrene is the term used to describe a form of gangrene brought on by an infection of some kind. It happens after an injury, like a burn or frostbite, that then becomes infected with bacteria. The inflammation that results from the body’s attempt to fight off infection can lead to a reduction in blood circulation, which in turn can deprive a portion of the body of oxygen and nutrients, resulting in gangrene. People with diabetes and a weakened immune system are at a greater risk of developing this type of gangrene.
Precautions for diabetic patients
● A high blood sugar level can induce nerve damage (neuropathy) and damage to blood vessels (vascular disease), leading to difficulties with the feet. You can lower your chance of having these issues if you control your blood sugar levels by maintaining a healthy diet, engaging in regular physical activity, and taking medication as directed.
● Examine your feet daily and be on the lookout for any injuries, such as cuts, blisters, redness, or swelling. Use a mirror or ask someone for help if you cannot view the bottoms of your feet. Foot problems can be prevented from becoming even more severe if diagnosed and treated as quickly as possible.
● It is essential to refrain from smoking because doing so can cause damage to blood vessels and restrict circulation to the foot, both of which can slow the healing process and raise the risk of infection. Ending smoking can help improve blood flow and minimize the likelihood of developing foot problems.
● Every day, people with diabetes should examine their feet for any signs of minor injuries or infections that they might not have been able to feel previously. Patients need to practice proper foot hygiene by keeping their feet dry and warm at all times. Frequent breaks to rest the feet are required.
How to treat gangrene?
Several different approaches can be taken to treat gangrene. Removing diseased or contaminated tissue from your body is one of the primary objectives of the treatment. It is imperative to either stop the progression of the infection or treat it to improve the circulation of your blood.
Tissue removal
Your healthcare professional might undergo conventional surgery to remove contaminated or dead tissue. Another treatment option is something called larval debridement therapy, which is a form of biosurgery. Your diseased or damaged tissue can be removed using maggots raised in a laboratory. Amputation is yet another method that can be used during surgery. If the gangrene is severe and threatens more of your healthy tissue, this may be the only choice left for you to consider.
Control of infectious diseases
When a bacterial infection causes gangrene, the prescribed antibiotics must be taken in the correct quantity.
The restoration of blood flow
➔ During bypass surgery, the surgeon will design a new pathway around the obstruction so that your blood can flow normally.
➔ During an angioplasty procedure, a physician will inflate a tiny balloon and place it within an artery to widen the blood flow passageway.
Additional treatments that are helpful for persons who have gangrene include the following:
➢ During hyperbaric oxygen therapy, often known as HBOT, high oxygen concentrations are pumped through your body’s tissues, which aid in the healing process. People with gas gangrene or gangrene from diabetic foot ulcers might benefit from this treatment.
➢ During a skin transplant, your healthcare practitioner will cover scars or damaged skin on areas of your body with healthy skin harvested from another location.
Conclusion
Diabetic foot and gangrene can lead to substantial health issues and, in extreme situations, even amputation. It is possible to lower one’s chance of developing diabetic foot and gangrene by implementing preventative measures such as regular foot care, maintaining good blood sugar levels, and smoking cessation. However, one must make an appointment with the endocrinology department as soon as possible once an early diagnosis is made to minimize the risk of consequences and maximize treatment success.
Also, one can consult Dr Ashish Airen, who offers gangrene treatment in Jaipur and possess an experience of more than 15 years in this field. Dr Ashish is the best vascular surgeon in Jaipur, and has treated hundreds of patients in this field.