gangrene of the feet photoGangrene is one form of death (necrosis) of tissues. The most common cause gangrene is injury to the blood vessels, blockage of blood vessels embolus, a blood clot, changes vessels in atherosclerosis, a variety of infections (typhus and other), long-vascular spasm, for example on grounds of chronic poisoning LPV, increased blood coagulability/violation of vasomotor innervation of the Central or peripheral origin. The development of gangrene contribute to heart failure, chronic intoxication (alcohol, phosphorus, nicotine), starvation, cooling, avitaminosis, metabolism diseases, especially diabetes.
There are two types of gangrene - dry and wet. When dry gangrene is mummification body tissues observed picture of coagulation necrosis. The damaged area is gradually dries up, wrinkled, is a dense, blood pigment fabric paints a dark brown color.
Wet gangrene is caused by the same reasons that and dry, but runs in the background of excess moisture on dead tissue, which contributes to the development of putrefactive infection (see). Under the influence of proteolytic enzymes tissue melt and take the form of a stinking mass of dirty-grey color. An example is the gangrenous changes in the vermiform Appendix, gall bladder (gangrenous appendicitis, gangrenous cholecystitis). The development of wet gangrene causes intoxication, accompanied by high temperature and the overall poor condition. Particularly easy moist gangrene occurs in patients with diabetes mellitus.
Treatment. At the first signs of the development of gangrene necessary to take measures to limit the process and prevention of infection. Assigned peace, aseptic bandage, anticoagulants, antibiotics. To suppress reflex spasm of blood vessels shown procaine perirenal blockade (see Blockade procaine). When dry gangrene is recommended to wait for education demarcation line, then make amputation in healthy tissues. At gangrene small areas of the body (nail phalanxes, nose, of the auricle) the dead tissue may be separated yourself. In progressive wet gangrene no signs of demarcation necessary early amputation.
Prevention: prevention, early diagnosis and treatment of diseases that can cause gangrene; reinstatement of the impaired circulation (removing spasm of the vessels, the development of collaterals and other).
Cm. also Necrosis.