From the Guidelines
Dry gangrene is characterized by a dry, shrunken, and mummified appearance with a dark brown, purple, or black discoloration, and a clear line of demarcation between healthy and dead tissue, as noted in the 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections 1. When dry gangrene occurs, the affected area becomes cold, hard, and leathery to the touch, with minimal or no bacterial infection, and often without a foul odor or discharge. Key signs of dry gangrene include:
- A dark brown, purple, or black discoloration of the affected area
- A clear line of demarcation between healthy and dead tissue
- Cold, hard, and leathery skin
- Minimal or no bacterial infection
- No foul odor or discharge
- Initial pain that often diminishes as nerve damage progresses According to the guideline, when all or part of a foot has dry gangrene, it may be preferable to let the necrotic portions auto-amputate, especially for patients who are poor surgical candidates 1. However, prompt medical attention is essential to prevent the spread of tissue death and potentially save the affected limb. The guideline also emphasizes the importance of considering vascular, reconstructive, and rehabilitation issues in selecting the level of amputation, and attempting to save as much of the limb as possible 1.
From the Research
Signs of Dry Gangrene
The signs of dry gangrene include:
- A change in skin color, which may appear red or black 2
- Numbness 2, 3
- Swelling 2
- Pain 2
- Ulceration 4, 2
- Detachment of local skin 2
- Tissue necrosis due to chronic ischemia, whereby the tissue becomes numb, dry, wrinkled, and dead 3
- Demarcated cold, dry, and dark discoloration of the affected area 5
- Loss of blood supply to the affected area, which can lead to gangrene 4, 2, 3, 5
Commonly Affected Areas
Dry gangrene commonly affects the:
Underlying Causes
Dry gangrene may arise due to: