Gangrene: what it is, symptoms, causes and treatment

The NHS describes gangrene as a serious condition where a body part, such as a toe or finger, begins to die. NI Direct explains that it is caused by a loss of blood supply to body tissue, and that it can affect any part of the body but typically starts in the toes, feet, fingers and hands.

Gangrene can occur as a result of an injury, an infection or a long-term condition that affects blood circulation.

The NHS lists the following signs. They can vary with the cause, and colour changes may be harder to see on brown or black skin.

• The affected body part turning a different colour, such as dark red, purple or black.

• The skin around it feeling numb or cold to the touch.

• Swelling of the skin around the affected body part.

• Pain that gradually gets worse, or a sudden severe pain.

• Blisters and sores that leak unpleasant-smelling pus or blood.

NI Direct says that if the area is infected you may also have a high temperature, loss of appetite, a rapid heartbeat and breathing, dizziness and shivering. In some cases the affected limb may feel heavy and pressing the skin may produce a crackling sound caused by a build-up of gas under the skin.

If bacteria pass into the bloodstream you could go into septic shock, a life-threatening condition. Signs include a rapid but weak pulse, dizziness when you stand up, confusion or disorientation, difficulty breathing, vomiting, diarrhoea, and cold, clammy, pale skin. Dial 999 immediately if you think you or someone you know is in septic shock.

The NHS says gangrene is mainly caused either by the blood supply to part of the body becoming blocked, or by an infection, usually after a serious injury or wound. You are more likely to get it if you have any of the following.

The NHS says you may have several tests while in hospital: blood tests, a biopsy (a small sample of skin or muscle tested for infection), scans such as ultrasound, X-rays, CT and MRI, and angiography, a type of X-ray used to look at blood vessels. In very serious cases, surgery may be needed to check if gangrene has spread inside the body.

The NHS says treatments can include surgery to remove dead tissue (debridement) or to restore blood supply (vascular surgery), antibiotics to treat infection, painkillers, medicines to improve blood supply, and oxygen therapy, where you breathe pure oxygen inside a small chamber, to try to speed healing.

Sometimes it may be necessary to completely remove the affected body part (amputation) if other treatments have not helped or are unlikely to help. If tissue is removed, you may need reconstructive surgery later, often using skin from another part of your body.

NI Direct stresses that the earlier treatment begins, the more successful it is likely to be.

The NHS says you can reduce the risk of gangrene by quitting smoking, eating a healthy diet, exercising regularly, losing weight if overweight or obese, and keeping taking treatments for diabetes, high blood pressure or high cholesterol. If you have diabetes, check your feet every day for swelling or changes in skin colour, tell your doctor about any changes and attend your diabetes check-ups and screening appointments.

NI Direct adds that you should report any wound that is unusually slow to heal to your GP as soon as possible.

The NHS says to call 999 or go to A&E immediately if you think you have gangrene. Do not drive yourself; ask someone to drive you or call 999 and bring any medicines you take.

NI Direct says to contact your GP immediately if you have any symptoms of gangrene, a persistent fever or a wound that is unusually slow to heal, and to call the out-of-hours service if your GP is not available.

Suspected gangrene is an emergency pathway through A&E or a hospital vascular or surgical team, so there is no waiting list route. For prevention, diabetic foot checks and vascular clinics are available through the NHS.