Gangrene Symptoms and Signs

Dry, Wet, Gas, and Fournier’s Gangrene

A patient’s symptoms will depend on the type of gangrene, the location of the gangrene (internal organs, skin, extremity, etc.), and how much the gangrene has progressed.

• In dry gangrene, the skin is hard and black or purplish. In earlier stages, the skin may be pale and either numb or painful.
• In wet gangrene, the affected area will be swollen with blisters oozing fluid; and the area may be red and warm with a foul odor.
• Gas gangrene causes severe pain, fever, and the skin will crackle like bubble wrap when pressed.
• Fournier’s gangrene will cause redness and swelling in the genital area. Patients with gangrene affecting internal organs such as the gallbladder or intestines will typically be very sick with fever, low blood pressure, and severe pain.

What is the difference between wet and dry gangrene?

Wet gangrene

Wet gangrene (also termed moist gangrene) is the most dangerous type of gangrene because if it is left untreated, the patient usually develops sepsis and dies within a few hours or days. Wet gangrene results from an untreated (or inadequately treated) infection in the body where the local blood supply has been reduced or stopped by tissue swelling, gas production in tissue, bacterial toxins, or all of these factors in combination. Additionally, conditions that compromise the blood flow such as burns or vascular trauma (for example, a knife wound that cuts off arterial flow) can occur first. Then the locally compromised body part or area becomes infected, which can result in wet gangrene. Wet gangrene is the type that is most commonly thought of when the term gangrene is used. Wet gangrene often produces an oozing fluid or pus, hence the term “wet.” Early stages of wet gangrene may include:

• Signs of infection
• Aching pain with swelling
• A reddish skin color or blanched appearance if the area is raised above level of the heart
• Coolness on the skin surface
• Ulceration
• A crackly sensation when the skin is pressed due to gas in the tissue

These stages may progress rapidly over hours to days.

Dry gangrene

Dry gangrene, if it does not become infected and progress to wet gangrene, usually does not cause sepsis or death. However, it can result in local tissue death with the tissue eventually being sloughed off. Usually, the progression of dry gangrene is much slower (days to months) than wet gangrene because the vascular compromise slowly develops due to the progression of diseases that can result in local arterial blockage over time.

The stages are similar to wet gangrene (see above), except there is no infection, pus, wetness, or crackly-feeling skin because there is no gas production in the uninfected tissue. Disease-fighting cells are not recruited to the area.

There are many diseases that may lead to dry gangrene; the most common are:

Infrequently, dry gangrene can occur quickly, over a few hours to days, when a rapid arterial blockage occurs in part of the body (for example, an arterial blood clot suddenly occludes a small artery to a toe). Dry gangrene often produces cool, dry, and discolored appendages (sometimes termed “mummified”) with no oozing fluid or pus, hence the term “dry.”