Diagnosis

Tests used to help make a diagnosis of gangrene include:

  • Blood tests. An abnormally high white blood cell count is usually a sign of infection. Your doctor might also order blood tests to look for the presence of specific bacteria or other germs.
  • Fluid or tissue culture. Tests of the fluid from a blister on your skin may be examined for bacteria that can cause gangrene. Your doctor may look at a tissue sample under a microscope for signs of cell death.
  • Imaging tests. X-rays, computerized tomography (CT) scans and magnetic resonance imaging (MRI) scans can show your organs, blood vessels and bones. Your doctor can use the results of these tests to determine how far the gangrene has spread throughout your body.
  • Surgery. Surgery may be done to get a better look inside the body and learn how much tissue is infected.

More Information

Treatment

Tissue that has been damaged by gangrene can't be saved, but steps can be taken to prevent gangrene from getting worse. The faster you get treatment, the better your chance for recovery.

Treatment for gangrene may involve medication, surgery or hyperbaric oxygen therapy — or a combination of these therapies — depending on the severity of your condition.

Medications

Medications to treat a bacterial infection (antibiotics) are given through an IV or taken by mouth.

Pain medications may be given to relieve your discomfort.

Surgery or other procedures

Depending on the type of gangrene you have and its severity, you may need more than one surgery. Surgery for gangrene includes:

  • Debridement. This type of surgery is done to remove the infected tissue and stop the infection from spreading. Your doctor may also perform surgery to repair any damaged or diseased blood vessels to restore blood flow to the infected area. Your doctor may prescribe certain antibiotics until the infection is cleared.
  • Amputation. In severe cases of gangrene, the infected body part — such as a toe, finger, arm or leg — may need to be surgically removed (amputated). You may later be fitted with an artificial limb (prosthesis).
  • Skin grafting (reconstructive surgery). Sometimes, surgery is needed to repair damaged skin or to improve the appearance of gangrene-related scars. Such surgery may be done using a skin graft. During a skin graft, your doctor removes healthy skin from another part of your body — usually a place hidden by your clothing — and carefully spreads it over an affected area. The healthy skin may be held in place by a dressing or by a couple of small stitches. A skin graft can be done only if there is enough blood supply to the area.

Hyperbaric oxygen therapy

Hyperbaric oxygen therapy is done inside a chamber pressurized with pure oxygen. You usually lie on a padded table that slides into a clear plastic tube. The pressure inside the chamber will slowly rise to about 2.5 times normal atmospheric pressure.

When you're safely exposed to increased pressure and oxygen, your blood can carry more oxygen. Oxygen-rich blood slows the growth of bacteria that live in tissue lacking oxygen and helps infected wounds heal more easily.

The treatment for gangrene generally lasts about 90 minutes. You may need two to three treatments every day until the infection clears.

Preparing for your appointment

Call your doctor right away if you have symptoms of gangrene. Depending on the severity of your symptoms, you may be told to go to the emergency room or to call 911 or your local emergency number for medical help.

If you have time before you leave home or on the way to the hospital, use the information below to get ready for your medical evaluation.

What you can do

  • Write down any symptoms you've been experiencing and for how long. It will help your doctor to have as many details as possible about when your symptoms first appeared and how they may have worsened or spread over time.
  • Write down any recent injury or trauma to your skin, including cuts, bites, injections, surgery or possible frostbite. If you have recently used injectable recreational drugs, this is critical information to share with your doctor.
  • Write down your key medical information, including any other conditions with which you've been diagnosed. Also write down all medications, vitamins or supplements that you're taking.
  • Take a family member or friend along. Gangrene is a medical emergency. Take someone with you to help you remember all the information your doctor provides. You'll also want someone who can stay with you if you need immediate treatment.
  • Write down questions to ask your doctor.

For gangrene, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms or condition?
  • What kinds of tests do I need?
  • Do I need to be hospitalized?
  • What treatments do I need?
  • How soon do you expect my symptoms to improve with treatment?
  • Will I have a full recovery? If so, how long will recovery take?
  • Am I at risk of long-term complications?

Don't hesitate to ask your doctor any additional questions you have.

What to expect from your doctor

Your doctor is likely to ask you several questions to help determine the next steps in making your diagnosis and starting care. Your doctor may ask:

  • What are your symptoms?
  • When did you first begin experiencing symptoms?
  • How painful is the affected area?
  • Do your symptoms seem to be spreading or getting worse?
  • Have you had any recent injuries or trauma to your skin, such as cuts, wounds, bites or surgery?
  • Have you recently had any prolonged exposure to extreme cold that made your skin change color or turn numb?
  • Do you use injectable drugs, including recreational drugs?
  • Have you been diagnosed with any other medical conditions?
  • What medications are you taking or have recently taken, including prescription drugs, over-the-counter medications, herbs and supplements?
Feb. 11, 2021
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  5. Novara E, et al. Severe acute dried gangrene in COVID-19 infection: A case report. European Review for Medical and Pharmacological Sciences. 2020; doi:10.26355/eurrev_202005_21369.
  6. Kang S, et al., eds. Necrotizing fasciitis, necrotizing cellulitis, and myonecrosis. In: Fitzpatrick's Dermatology. 9th ed. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. Accessed Jan. 27, 2021.
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  9. Conte MS, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. European Journal of Vascular and Endovascular Surgery. 2019; doi:10.1016/j.ejvs.2019.05.006.

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