IN 1939 a study was made of the amputations done for diabetic gangrene and infection at the Buffalo General Hospital during the preceding seven years. The mortality for all cases was 35 per cent and for major amputations, 41 per cent. A review of the literature showed that these were not comparatively high figures, although a few centers were beginning to report reduction in mortality through methods aimed at quick riddance of infection. There had been no significant reduction in the mortality in this hospital during the seven years covered by the study. Analysis disclosed that in 75 per cent of all our cases there was some infection of the stump or amputation site. In all the fatal cases postoperative infection had been present.
It seemed, then, that postoperative infection played the major role in maintaining the high mortality rate. The factors of age, blood supply and severity of diabetes