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Gangrene
Last reviewed: 04.07.2025
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[ What causes gangrene?
Gangrene is based on vascular disorders, primarily arterial blood flow. With rapid circulatory disorders, the destructive process occurs almost lightning fast. This happens with thromboses, ruptures, strangulation of arteries (rarely veins, for example, thrombosis of the mesenteric veins, superior vena cava), under the influence of microflora, for example, anaerobic.
In parenchymatous organs, the process of tissue necrosis has a peculiar character, which is called an infarction: heart, lungs, liver, spleen, kidneys. In uncomplicated cases, infarction zones undergo lysis with resorption and replacement with scar tissue, or they are encapsulated (the capsules are mostly fibrous). But in infarctions, inflammation can develop at any time in the event of infection (for example, in the lung: infarction-pneumonia or abscess during infarction encapsulation, and in the event of putrefactive microflora, gangrene can develop). Necrosis of brain areas is called "stroke", which, if the course is favorable, undergoes softening and lysis without scarring: Gangrene of the brain is not discussed due to the rapid death of the patient.
In case of slow development of circulatory disorders - in obliterating diseases, angiotrophoneurosis, vasculitis, diabetic angiopathy - the prenecrotic phase is long, accompanied initially by tissue atrophy, and then by the development of gangrene with decompensation of blood flow. One of the forms of gangrene of the skin and subcutaneous tissue are bedsores, which arise due to prolonged compression of tissues in a forced position and disruption of microcirculation in them.
How does gangrene manifest itself?
Gangrene is divided according to its clinical course into dry, wet, and anaerobic (gas).
Dry gangrene is usually superficial or affects small distal areas of a limb segment, such as one or more fingers. It is brown or black in color, the demarcation line is well defined, the surrounding tissues, although atrophic, have no signs of inflammation. There is no general reaction of the body to the process, only manifestations of the underlying and associated diseases.
Wet gangrene of the extremities and internal organs is accompanied by rapid spread of edema and hyperemia, involvement of the lymphatic system in the process, rapid destruction of tissues, and increasing general intoxication of the body. Areas of dry necrosis may remain, but around them, "edema and hyperemia of tissues develop. Gas gangrene occupies a special place