Gangrene Localized to the Lower Limbs in Diabetics

Abstract

Over a period of eight years, 247 unselected patients with more or less widespread areas of obvious cutaneous erythema on the lower legs and/or feet (incipient gangrene) or corresponding areas with cutaneous necrosis (manifest gangrene) were examined at our department. Of these patients, 34% had incipient and 66% manifest gangrene. It was found that 75% had open diabetes; the others were classified as non-open diabetics. In 75 % of the 247 patients these lesions accompanied cardiac decompensation with or without edema, edema of other causes or-in some cases-arterial insufficiency. The gangrene developed in most patients a short time after the onset of these precipitating factors. Arterial insufficiency alone or together with other precipitating factors was seen considerably less often. Edema was thus the main precipitating factor for these lesions. Cardiac decompensation as well as edema of the legs due to other causes respond well to treatment. When treating such patients with open or nonopen diabetes, it should be taken into consideration that gangrene is a serious condition.

Gangrene Localized to the Feet in Diabetic Patients

“…Over a period of more than 10 years we have studied patients with open and non-open diabetes and with more or less widespread areas of obvious cutaneous erythema on the lower limbs (incipient gangrene) or corresponding areas with cutaneous necrosis (manifest gangrene) (1)(2)(3)(4)(5)(6). The patients were classified in two groups.…”

Characteristic Lesions Localized to the Lower Limbs in Patients with Open and Not Open Diabetes

“…Most of the patients with incipient or manifest gangrene (1,3,5,6), skeletal destruction of the feet (3), shin spots (7), purpura ( 2 ) and yellow toe nails The diagnosis of diabetes in patients without glucosuria, especially in the elderly, can very often be made with a great certainty only by inspection of the lower extremities.…”