What is Gangrene?

So, gangrene is death of tissue, gangrene is necrotic, necrosis means death of tissue, so necrotic tissue and you can see gangrene quite clearly as it presents often with a sort of blackened area. So you can see, you know, we would see gangrene sometimes in the heels, sometimes in the toes, as a blackened area. Gangrene can be dry gangrene, so it can be completely dry and sort of hard like a scab or like an eschar that you can see, or it can be wet in case in which case it's sort of like soggy leather, it's got this very sort of dense consistency and it's sort of like a more of a dark brown, dark green colour as opposed to black and it may be associated if it's wet gangrene with quite a lot of swelling and redness, it may be associated with quite a lot of odour and exudate and wet gangrene needs urgent referral and urgent review by the medical team or the surgical team because it is a clinical emergency. Dry gangrene often, in my practice, we would see dry gangrene in people who perhaps have necrotic toes where the the blood supply to a toe has shut off and they develop a sort of necrosis at the ends of their toes. And sometimes with these, we will, whilst we know about them, we'll monitor them. So they'll be under the care of the vascular team and we will monitor that gangrene to one, to make sure it's not spreading and two, to encourage what we call auto-amputation. And this is where the gangrene sort of demarcates from the healthy tissue. So we have an area where the tissue is healthy and then we'll have a sort of what we call the demarcation line, a kind of line in the tissue beyond which the tissue is dead. And we protect the demarcation line to allow the dead tissue to slough off. And we often find that with people with localized, particularly digital gangrene, we can allow auto-amputation to naturally occur and preserve as much of the foot as we can without the need for surgical intervention.