Factors affecting outcome of diabetic patients with foot ulcers or gangrene

This paper reports the outcome in 205 diabetic patients with foot ulcers or gangrene. The circulation to the foot was assessed using a radioisotope clearance test to measure the skin perfusion pressure (SPP) and skin vascular resistance (SVR) in the foot. Factors important in predicting initial healing were the age of the patient, SPP and SVR but not the ankle pressure index. The factors predicting death during 6-42 months follow-up were age and initial SPP; half the patients had died or under-gone amputation at 22 months. The information from the radioisotope clearance test is important in helping determine appropriate management for these patients and provides information not available from other methods, such as the ankle pressure measurement.