Gangrene refers to the death and decay of tissues resulting from an interruption of blood flow caused by a bacterial infection. Gangrene most commonly occurs in the extremities, including fingers, toes and limbs, but may occur in muscles and internal organs. Patients are at greater risk for developing gangrene if they suffer from an underlying vascular deficiency, such as diabetes or atherosclerosis. Treatments for gangrene vary based on the type of gangrene and the location, but often include a combination of surgery, antibiotics and oxygen therapy.
Surgical Excision
Physicians will perform surgery to remove the decaying tissue to help keep the bacteria from spreading to other healthy tissues. Dependent upon where the destroyed tissue lies, the physician may opt to amputate the affected limb or extremity. In cases where it is unclear how far the bacteria has spread, physicians may decide to remove more tissue rather than less to prevent a patient from having to undergo the trauma of a second surgery in the event the bacteria had spread past the point of amputation.
Skin Graft
Physicians may also perform a skin graft to reconstruct the skin damaged by the gangrene. A skin graft involves the removal of a patch of skin from one part of the body to transplant to another. During the skin graft procedure, doctors harvest healthy skin from the donor site, usually the buttocks or thigh, and spread it over the affected area.
There are two types of skin grafts. A split-thickness skin graft harvests the top two layers of skin and the layer just beneath from the donor site for transplantation. This type of skin graft requires the patient to have adequate blood supply to the donor site. A full-thickness skin graft removes the skin, muscles and blood supply from the donor site. The National Institute of Health says that a full-thickness skin graft is a far more complicated procedure used only for patients with deeper tissue damage or loss. Risks for skin graft surgeries include bleeding, infection, loss of the grafted skin, loss of skin sensation, chronic pain, uneven skin surface and skin discoloration.
Hyperbaric Oxygen Therapy
Physicians may recommend hyperbaric oxygen therapy to treat a specific form of gangrene known as gas gangrene. Gas gangrene typically affects deep muscle tissue and is often caused by bacteria known as Clostridium perfringens. Doctors place the patient in a hyperbaric chamber that delivers oxygen under increased pressure. The increased pressure and oxygen content allow the blood to carry more oxygen. Oxygen-rich blood inhibits the growth of bacteria and helps infected wounds heal more easily, according to MayoClinic.com. Hyperbaric oxygen therapy may require up to three treatments on the first day and lasts approximately 90 minutes. Patients will also undergo an additional two treatments a day for five days. During oxygen therapy, patients may feel lightheaded and tired and may experience an increase in ear pressure.
