Any condition that cuts off blood supply can cause gangrene. Common causes include:

• Injuries.

• Blood vessel diseases.

• Diabetes.

• Infections.

You may be at increased risk for gangrene if you have recently had surgery, or if you have:

• A serious injury.

• Diabetes.

• A weak disease-fighting system (immune system).

• Narrowing of your arteries due to plaque buildup (arteriosclerosis).

• An immune system disease that causes your arteries to tighten (Raynaud’s disease).

• A history of IV drug use.

Symptoms depend on which part of your body is affected. If you have external gangrene, you may have:

• Severe pain, followed by loss of feeling.

• Redness and swelling.

• Crackling sounds when you press on a swollen area of skin.

• A wound with bad-smelling drainage.

• Changes in the color of your skin. It may turn red, blue, black, or white.

• Fever and chills.

If you have internal gangrene, you may have:

• Fever and chills.

• Confusion.

• Dizziness.

• Severe pain.

• Rapid heartbeat and breathing.

• Loss of appetite.

• Nausea or vomiting.

This condition may be diagnosed based on:

• Your symptoms and medical history.

• A physical exam.

• X-rays of your blood vessels after injecting dye into your blood vessels (arteriogram).

• Blood tests to check for infection.

• Imaging tests such as a CT scan or MRI.

• Testing a sample of wound drainage for bacteria (culture).

• Testing a tissue sample for cell death (biopsy).

• Surgery to look for gangrene inside your body.

Treatment for gangrene depends on the cause and the area of your body that is affected. Gangrene is usually treated in the hospital. It is very important to start treatment early, before gangrene spreads. Treatment may include:

• High doses of IV antibiotic medicine, for gangrene caused by infection.

• Surgery. Surgical options may include:

  • Debridement. This is surgery to remove dead tissue. You may need to have debridement several times.

  • Bypass or angioplasty. These surgeries improve blood flow to an affected area.

  • Amputation. This is surgery to remove a body part. This may be necessary in very severe cases.

• Oxygen therapy. This involves treatment in a chamber designed to provide high levels of oxygen (hyperbaric oxygen therapy). It can improve the oxygen supply to an affected area.

• Supportive care to keep the rest of your body healthy. This may include:

  • IV fluids and nutrients.

  • Pain medicines.

  • Blood thinners to prevent blood clots.

Skin and wound care

• Clean any cuts or scratches with a germ-killing (antiseptic) solution. Your health care provider may recommend certain over-the-counter antiseptics.

• Cover any open wounds with a clean bandage. Change the bandage as often as needed to keep the wound clean. Make sure to wash your hands before touching your bandage.

• Check wounds every day for signs of infection, such as:

  • Redness, swelling, or pain.

  • Fluid or blood.

  • Warmth.

  • Pus or a bad smell.

• If you have diabetes or another blood vessel disease, check your feet every day for signs of injury or infection. You may be at higher risk for gangrene.

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay wound healing. If you need help quitting, ask your health care provider.

• Limit alcohol intake to no more than 1 drink a day for women (no drinks if you are pregnant) and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

• Eat a healthy diet and maintain a healthy weight.

• Get some exercise on most days of the week. Ask your health care provider what forms of exercise may be best for you.

General instructions

• Keep all follow-up visits as told by your health care provider. This is important.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.

• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

• If you are taking blood thinners:

  • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.

  • Take your medicine exactly as told, at the same time every day.

  • Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.

  • Wear a medical alert bracelet or carry a card that lists what medicines you take.