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Dry gangrene


more often develops with circulatory disorders of the extremities in depleted, dehydrated patients. With the slow development of necrosis, the tissues dry, wrinkle, mummify, become dense and turn dark brown or black with a bluish tint. Dry gangrene usually does not progress, being limited to part of a limb segment. The onset of clinical manifestations is characterized by the appearance of severe ischemic pain below the site of blockage of the vessel. The limb becomes pale, then the skin takes a marble look, it becomes cold to the touch, the pulse is not palpable.
Sensitivity is lost, there is a feeling of numbness of the leg. Pain sensations last for a long time, which is explained by the preservation of nerve cells among dead tissues and reactive tissue edema above the focus of necrosis.
Along with impaired patency of the main main vessel, a spasm of collateral arterial branches is usually noted, which accelerates and expands the necrotic process. Starting from the peripheral parts of the limbs, gangrene spreads up to the level of occlusion of the vessel or slightly lower. With a favorable course, a demarcation (protective) shaft gradually develops at the border of dead and healthy tissues. Complete tissue rejection and recovery is a long process. Microorganisms in dry tissues do not develop well, however, in the initial phases putrefactive microflora caught in them can cause the transition of dry gangrene to wet. In this regard, adherence to asepsis is especially important before tissue drying.
With dry gangrene, there is almost no decay of dead tissue, and the absorption of toxic products is so insignificant that intoxication is not observed. The general condition of the patient suffers little. This allows, without great risk, to postpone the operation to remove dead tissue (necrectomy) or amputation until a complete and distinct manifestation of the demarcation shaft.