Management of gangrene in diabetic extremities

The long-term complications of diabetes mellitus occur despite insulin therapy. One of these complications is gangrene of an extremity which is a prime cause of morbidity and mortality in diabetic patients. Peripheral occlusive vascular disease frequently underlies the gangrene and this challenges the surgeon to revascularize the limb and to limit the amputation to the gangrenous tissue. The author describes six diabetic patients with gangrene of an extremity treated at the Riverside Hospital in Ottawa to illustrate how this condition may be managed by revascularization with no amputation or with conservative amputation and debridement. Major amputation was avoided in all six patients.