Gangrene: Tissue Necrosis, Types, and Urgent Management

Gangrene is necrosis (tissue death) with secondary decomposition, usually from critical ischemia or infection.

Types

• Dry gangrene: Ischemia without infection; tissue shrinks, turns black/mummified. Slow progression.
• Wet gangrene: Ischemia + bacterial infection; edema, blisters, foul smell, rapid spread. Life-threatening sepsis risk.
• Gas gangrene: Clostridial myonecrosis; gas in tissues, crepitus, rapid toxemia.
• Fournier's gangrene: Necrotizing fasciitis of perineum/genitalia.

Etiology

Peripheral arterial disease, diabetes, trauma, frostbite, embolism, immunocompromise.

Treatment

Emergent surgical debridement/amputation, broad-spectrum antibiotics, revascularization if feasible, hyperbaric oxygen (clostridial), glycemic control. Delay increases mortality.