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Risk factors
By Mayo Clinic staffSeveral factors increase your risk of developing gangrene. These include:
- Age. Gangrene occurs far more often in older people.
- Diabetes. If you have diabetes, your body doesn't produce enough of the hormone insulin (which helps your cells take up blood sugar) or is resistant to the effects of insulin. High blood sugar levels can eventually damage blood vessels, interrupting blood flow to a part of your body.
- Blood vessel disease. Hardened and narrowed arteries (atherosclerosis) and blood clots also can block blood flow to an area of your body.
- Severe injury or surgery. Any process that causes trauma to your skin and underlying tissue, including an injury or frostbite, increases your risk of developing gangrene, especially if you have an underlying condition that affects blood flow to the injured area.
- Obesity. Obesity often accompanies diabetes and vascular disease, but the stress of extra weight alone can also compress arteries, leading to reduced blood flow and increasing your risk of infection and poor wound healing.
- Immunosuppression. If you have an infection with the human immunodeficiency virus (HIV) or if you're undergoing chemotherapy or radiation therapy, your body's ability to fight off an infection is impaired.
- Medications. In rare instances, the anticoagulant drug warfarin (Coumadin) has been known to cause gangrene — especially in combination with heparin therapy.
References
- Neschis DG, et al. Clinical manifestations and evaluation of chronic critical limb ischemia. http://www.uptodate.com/home/index/html. Accessed May 16, 2011.
- Park H, et al. Complex wounds and their management. Surgical Clinics of North America. 2010;90:1181.
- Helviz Y, et al. Bad to worse. The American Journal of Medicine. 2011;124:215.
- Sepsis and septic shock. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec06/ch068/ch068a.html. Accessed May 15, 2011.
- Stevens DL, et al. Clostridial myonecrosis. http://www.uptodate.com/home/index.html. Accessed May 16, 2011.
- Gas gangrene. American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/conditions/skin/pages/Gas-Gangrene.aspx. Accessed May 16, 2011.
- Mechem C, et al. Frostbite. http://www.uptodate.com/home/index/html. Accessed May 15, 2011.
- Stevens DL. Necrotizing infections of the skin and fascia. http://www.uptodate.com/home/index/html. Accessed May 16, 2011.
- Intestinal obstruction. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch011/ch011h.html. Accessed May 26, 2011.
- Mandell JE, et al. Necrotizing fasciitis, Fournier's gangrene In: Mandell JE, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/page.do?sid=1163686964&eid=4-u1.0-B978-0-443-06839-3..00043-6--s0035&isbn=978-0-443-06839-3&uniqId=251414141-4. Accessed May 23, 2011.
- Mechem C, et al. Hyperbaric oxygen therapy. http://www.uptodate.com/home/index/html. Accessed May 20, 2011.
- Fujiwara Y, et al. Beneficial effects of foot care nursing for people with diabetes mellitus: An uncontrolled before and after intervention study. Journal of Advanced Nursing. In press. Accessed May 26, 2011.
- Saavedra A, et al. Soft-tissue infections: Erysipelas, cellulitis, gangrenous cellulitis, and myonecrosis. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=2995017&searchStr=gangrene#2995017. Accessed May 27, 2011.
- Coumadin (prescribing information). New York, N.Y.: Bristol-Myers Squibb; 2005. http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/009218s101lbl.pdf. Accessed May 31, 2011.
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