From the Guidelines
Dry gangrene is a condition where body tissue dies due to lack of blood supply, characterized by the affected area becoming dry, shriveled, and blackened, and it may be preferable to let the necrotic portions auto-amputate, especially for patients who are poor surgical candidates 1. When dry gangrene occurs, it typically develops gradually, affecting extremities like toes, fingers, feet, or hands, particularly in people with compromised circulation. Unlike wet gangrene, dry gangrene doesn't involve infection and progresses more slowly. The affected tissue becomes cold, numb, and changes color from pale to brown, purple, and eventually black. Some key points to consider in the management of dry gangrene include:
- Addressing the underlying cause, such as peripheral artery disease, diabetes, or atherosclerosis, to improve circulation and prevent further tissue damage 1.
- Carefully observing the effectiveness of medical therapy and the demarcation line between necrotic and viable tissue before operating, and considering surgical intervention if clinical findings worsen 1.
- Leaving adherent eschar in place, especially on the heel, until it softens enough to be more easily removed, provided that there does not appear to be an underlying focus of infection 1.
- Considering surgical removal of dead tissue (debridement) or amputation in severe cases, and attempting to save as much of the limb as possible 1. Prevention of dry gangrene involves managing conditions like diabetes and cardiovascular disease, avoiding tobacco, maintaining proper foot care, and seeking prompt medical attention for circulatory problems. Dry gangrene is a serious condition requiring immediate medical care to prevent further tissue damage and potential complications.
From the Research
Definition of Dry Gangrene
- Dry gangrene is a condition characterized by the death of tissue due to a lack of blood supply, often occurring in the extremities 2.
- It is a type of critical limb ischemia (CLI), which is defined as greater than 2 weeks of extremity rest pain, ulcers, or extremity gangrene, secondary to objectively proven peripheral artery disease (PAD) 2.
Causes and Risk Factors
- Dry gangrene is often caused by peripheral artery disease (PAD), which is a condition where the arteries that supply blood to the limbs become narrowed or blocked 3, 4.
- Risk factors for dry gangrene include smoking, diabetes, high blood pressure, and high cholesterol 2, 4.
Symptoms and Treatment
- Symptoms of dry gangrene may include pain, numbness, and discoloration of the affected area 2.
- Treatment for dry gangrene may involve medical therapy, such as wound care and antiplatelet therapy, as well as surgical options, such as amputation 2.
- Other treatments, such as pentoxifylline, may also be used to improve blood flow and reduce symptoms 5, 6.