A survey of the literature reveals that over 50% of diabetic patients who develop foot infections and gangrene ultimately require some form of amputation; diabetics are vulnerable to circulatory impairment and susceptible to superimposed infection. Experience with conservative management in 215 diabetic patients with gangrenous infections reveals that the amputation rate was reduced to 11%; other cases healed completely. The predominant problem was infection. Impaired blood flow, while playing a very important part, can be correlated generally with the time required for healing. The techniques for satisfactory treatment included the administration of appropriate antibiotics in adequate dosage, the local use of tri-iodide complex releasing free iodine as a potent antimicrobial agent, and precautionary measures to avoid tissue injury.
Collens WS, Vlahos E, Dobkin GB, et al. Conservative Management of Gangrene in the Diabetic Patient. JAMA. 1962;181(8):692–698. doi:10.1001/jama.1962.03050340030007
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