Burns Expert Forum
is it gangrene?
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is it gangrene?

i have a wart on my toe which was frozen on monday with histofreeze and doctor said if nothing happens use a cautic pencil..i used it on wednesday and now my toe is gone black and it it spreading and it is shrivelling up but no pain and i got feeling in my toe so i am not sure if it is gangrene or if it is normal results from using the caustic pencil..please help me i am getting it checked out by a pharmacist later today
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For the other readers, caustic pencils are long sticks that look like matches and on the tip they contain silver nitrate.  Silver nitrate when concentrated causes cauterization of tissue.   Silver nitrate is also capable of staining skin black.   When diltuted, silver nitrate is used as a topical antibiotic.  It used to be very popular and many burn centers around the world still use it.  When used as an antibiotic the problem was it stains everything black.  Often, its hard to tell burned from unburned tissue after everything has been stained.  Even the floors get stained blacked.  

You mention that the toe is looking shriveling up, that is rather worrisome for gangrene.  In your second foot you mention that you are diabetic and that the foot is infected.  This problem deserves some significant discussion.

-wounds or foot infection in diabetics are always a serious problem.  An infected foot infection in a diabetic is typically something that warrants hospital infection.  It is very easy for such an infection to get out of control as well as the infection to cause the diabetes out of control.  

-how serious is your diabetes and are you on insulin?   Diabetes causes narrowing of arteries that can greatly impair or slow wound healing.  Therefore, any wound may be difficult to heal.  Prior to any type of amputation, one has to determine if the wound will heal.   So the next question is do you have pain in your buttocks or legs when you walk a distance.   If you do, this would indicate arterial disease (not uncommon for a diabetic).  Why is this a big deal if your toe needs an amputation?   Well if you have arterial disease, the arteries might not be able to carry enough blood to heal the surgical wound.  If that were the case vascular surgeons might have to angioplasty a narrowed artery to improve blood flow and help wounds heal.

-infections cause diabetes to be more difficult to control.  When blood sugars are elevated, wounds don’t heal as well.  
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by the way i forgot to mention i am diabetic and the government hospital mccords reckons it is gangrene and they want me to come in to have my toe amputated as the infected area covers the top half of my toe just below the nail and it is looking ***** and infected!!!
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