[Treatment of diabetic gangrene]

The results of treatment in 68 patients with vascular lesions of the lower limbs in diabetes mellitus are analysed. Fifty patients showed a necrotic and gangrenous stage of the disease. A grave form of diabetes was observed in half of them. In every case of diabetic angiopathy of the lower extremities vessels, irrespective of the gravity and stage of the process, insulinotherapy should be instituted. A complex therapy and preoperative management also include an adequate physiological diet, spasmolytics, vitamins, antibiotics according to an antibioticogram, and anticoagulants, local enzymotherapy, if indicated. In 13 cases spontaneous sequestration occurred, 31 patients were operated upon: sequestration--in 6, amputation--in 25. The operation was performed after elimination of auetonuria and ketonuria and reduction of hyperglycemia as low as 200 mg% (the latter was gained but not always). Recently, low amputations have been accomplished more frequently than before. No postoperative mortality was noted.