Does A Delayed Gangrene Diagnosis Increase The Likelihood Of Amputation?

When we think of gangrene, many of us immediately think of amputation. However, gangrene is often treatable when caught early, and amputation is not always necessary. However, when healthcare workers don’t notice or misdiagnose the early signs of gangrene, amputation may be required to save the patient’s life.

What Is Gangrene?

Gangrene refers to tissue death and is usually caused by impaired blood flow, traumatic injury, or bacterial infection. Gangrene most commonly affects the extremities but can also occur within the body. There are several types of gangrene, including:

• dry – usually caused by circulation problems

• wet – caused by a combination of impaired blood flow and bacterial infection (it’s “wet” because blisters usually develop and burst on the skin)

• Fournier’s – bacterial gangrene that affects the genital area

• gas – caused by an infection deep inside the body, bacteria release toxins and gas into the surrounding tissue, resulting in rapid tissue death

• internal – this also occurs deep within the body but is usually caused by impaired blood flow due to blood clots, hardened arteries, or a strangulated hernia, which is when a part of the intestine becomes trapped, and the blood supply is cut off

While gangrene is relatively rare, critical limb ischemia (where blood flow is severely restricted in a limb, finger, or toe) affects 1 in 100 adults over the age of 50 and 1 in 50 adults over the age of 70. If left untreated, the condition can lead to dry gangrene. Gas gangrene is much less common, affecting around 1,000 Americans every year.

While anyone can be affected by gangrene, it’s more likely in people with:

• diabetes, particularly if it’s poorly controlled for an extended period
• blood vessel disease, such as atherosclerosis or blood clots
• injuries like frostbite, severe burns, crushing injuries, or severe blood loss
• smoking
• obesity
• suppressed or impaired immune system
• complications due to prolonged severe infections, such as COVID-19

How Is Gangrene Diagnosed?

Wet and dry gangrene tend to be much easier to identify than gas and internal gangrene. Still, the symptoms can be radically different depending on the type of gangrene and the underlying cause. The skin may be red and swollen, or it may look pale and feel cool to the touch. There may be severe pain in the area, or there may be a complete loss of feeling. The skin may be dry and wrinkled, or there may be an open wound with a foul smell. When it occurs in a limb or close to the skin’s surface, skin color usually changes as the condition progresses.

When bacteria are involved, particularly in the case of gas and internal gangrene, symptoms are initially the same as many other infections, causing chills, rapid heart rate, feeling hot or sweaty, fever, loss of appetite, and severe pain. If gangrene is allowed to spread, septic shock and death can occur quickly.

How Is Gangrene Treated?

Depending on the location and underlying cause, gangrene may be treated with antibiotics, oxygen therapy, and/or surgery to restore blood flow and remove dead tissue. Occasionally, gangrene is treated with larval debridement therapy, which uses maggots to remove damaged tissue without disturbing healthy tissue. This method takes longer than surgery but typically results in less trauma to healthy tissue. In severe cases, an entire limb may need to be amputated to keep gangrene from spreading. The earlier it’s identified and treated, the better the chances for recovery.

What Can Happen If Gangrene Isn’t Treated?

While all types of gangrene can spread to other parts of the body, they do so at different rates. Dry gangrene, usually caused by a circulation problem in a specific part of the body, is usually more localized but can spread up a limb slowly over days or even months. Wet gangrene, because it involves a bacterial infection, can spread quickly over hours or days, resulting in massive tissue loss, septic shock, and ultimately death. Gas gangrene can become deadly within only 48 hours, and Fournier’s gangrene has been known to cause tissue death at a rate of 1 inch per hour and can become life-threatening within hours.

While different types of gangrene have different survival rates, all types of gangrene can become deadly if left untreated for long enough. The average survival rate for all types of gangrene is around 75 percent.

Why Might A Gangrene Diagnosis Be Delayed?

Unfortunately, diagnoses are frequently delayed because many types of gangrene mimic the symptoms of other conditions in the early stages. Fournier’s gangrene, for example, is initially misdiagnosed in up to 75 percent of cases. Initially, gangrene may be mistaken for cellulitis, urinary tract infections, or other simple infections. Early symptoms of pain, fever, and malaise are common in many illnesses, making internal gangrene harder to detect. Some individuals delay seeking medical attention due to the mild nature of their initial symptoms, not realizing that for some types of gangrene, a few hours can be the difference between life and death.

Delayed diagnoses contribute to higher mortality rates for all types of gangrene, particularly internal, gas, and Fournier’s gangrene. Amputations also become necessary if a diagnosis is delayed. While amputation may be needed even if gangrene is identified early, it’s even more devastating to a patient and their family if it could have been prevented with a timely diagnosis and the appropriate treatment.

Why Choose Ross Feller Casey?

If you or a loved one suffered an amputation due to a misdiagnosis or delayed diagnosis of gangrene, you could be entitled to compensation. The legal team at Ross Feller Casey has an unmatched track record of success when it comes to medical malpractice cases, including delayed diagnoses leading to catastrophic injuries such as limb loss.

If you believe that a delayed gangrene diagnosis contributed to a preventable amputation, contact us today for a free consultation. There’s no fee unless you win, so don’t delay.