Gangrene of the lower limbs in diabetic patients: A malignant complication

Mottl Gutman, Ofer Kaplan, Yehuda Skomick, Joseph M. Klausner, Shlomo Lelcuk, Ron R. Rozin

Research output: Contribution to journalArticlepeer-review


Diabetic foot lesions are a common medical problem with major socioeconomic impact. Gangrene is usually a late and sometimes fatal complication. A series of 118 diabetic patients who underwent amputation of the lower limb at our institution over a 10 year period has been presented. Forty-two patients underwent amputation of the toes or part of the foot, 48 underwent below-knee amputation, and 18 underwent above-knee amputation. In 24 (20.3 percent), the necrotic process advanced postoperatively and necessitated additional amputation. The average hospital stay was 33.6 days. Twenty-eight patients (23.7 percent) died during the postoperative period, and the main cause of death was sepsis. Patients who presented with extensive gangrene had a higher mortality rate. There was no correlation between mortality and the duration of conservative treatment, number of repeated operations, the treatment of diabetes before hospitalization, onset of symptoms, or status of the peripheral pulses. The solution to the problem is early and vigorous preventive treatment. This could be accomplished through highly specialized clinics within the community.

Original languageEnglish
Pages (from-to)305-308
Number of pages4
JournalAmerican Journal of Surgery
Issue number3
StatePublished - Sep 1987


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