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Dry gangrene


often develops in violation of the circulation of the limb in exhausted, dehydrated patients. With the slow development of necrosis, the tissues dry out, shrivel, mummify, become dense and become dark brown or black with a bluish tint. Dry gangrene usually does not progress, limited to part of the limb segment. The onset of clinical manifestations is characterized by the appearance of severe ischemic pain below the site of vessel occlusion. The limb is made pale, then the skin takes on a marble look, it becomes cold to the touch, the pulse cannot be felt.
Loss of sensitivity, there is a feeling of numbness in the legs. Pain persists for a long time, which is explained by the preservation of nerve cells among the dead tissues and reactive tissue edema above the focus of necrosis.
Simultaneously with the violation of the patency of the main main vessel, usually a spasm of collateral arterial branches is noted, which accelerates and expands the necrotic process. Starting with the peripheral parts of the limbs, gangrene spreads up to the level of vessel blockage or slightly lower. With a favorable course on the border of dead and healthy tissues, a demarcation (protective) shaft gradually develops. Full tissue rejection and recovery is a long process. Microorganisms in dry tissues do not develop well, but in the initial phases, the putrefactive microflora that have entered them can cause the transition of dry gangrene into a wet one. In this regard, asepsis is especially important before the tissues dry out.
With dry gangrene, the decay of dead tissue almost never happens, and the absorption of toxic products is so insignificant that intoxication is not observed. The general condition of the patient suffers a little. This allows, without great risk, to postpone the operation of removing dead tissue (necroectomy) or amputation until the demarcation shaft is fully and clearly displayed.