2000 Sep;20(3):163-8. TCM stage differentiation treatment of diabetic gangrene--an observation on microcirculatory changes.

Microcirculatory changes and therapeutic effects in 39 non-insulin dependent diabetes mellitus (NIDDM) cases were evaluated. Under the same basic treatment in both groups, the treatment group (21 cases) was treated with TCM drugs according to its stages and compared with the control group (18 cases, treated with 654-2). The results showed that the microcirculatory cumulative scores were significantly decreased in both groups (P < 0.05), but the decrease in the treatment group was more marked (P < 0.05). In the treatment group, 15 cases were cured, 3 markedly effective, 2 effective and 1 ineffective; while in the control group, 13 cases were cured, 1 markedly effective and 4 ineffective. Statistically, there is no significant difference between the 2 groups (P > 0.05) in therapeutic effects.

1994 Jun;74(6):358-60, 391. [Comprehensive treatment for diabetes limb gangrene].

Anisodamine was used to improve general circulation and the microcirculation of affected limbs. Measures like local debridement, dressing change, and control of diabetes were applied in 351 patients with diabetic limb gangrene. Of the 351 patients, 301 (85.7%) were cured, 27(7.7%) were improved, 7(2.0%) failed, 6(1.7%) had limb amputated, and 10(2.9%) died. In the treatment, the nail-fold microcirculation was markedly improved. Doppler scan showed increased width and bloodflow of the vessels of the affected limbs. The criteria for the classification and diagnosis of diabetes limb gangrene are suggested.

2012 Dec;21(12):615-6, 618-9. Symmetrical peripheral gangrene and the use of systemic hyperbaric oxygen therapy.

Symmetrical peripheral gangrene (SPG) is a rare but devastating condition when two or more distal sites become gangrenous, as the result of severe illness and treatment in critical care. The striking factor in SPG is that there is no occlusion of the major blood vessels to the affected limbs; the pathogenesis of the condition is not well understood and there are high reported mortality and amputation rates. Here we report the chronological progress report of a case of SPG, which affected both forefeet. This case report supports the view that early amputation should be avoided allowing for stabilisation of the gangrene so that no viable tissue is sacrificed. Further research is necessary to establish the pathogenesis and suitable treatment pathways.

1957 May;15(5):689-700. Treatment of gangrene of the feet and legs by walking.

1950 Nov 10;89(45):1255-9. [Two acute cases of febrile gangrene of toes in both feet].

1974 Jul 30;63(30):909-12. [Conservative treatment of perforating ulcers and gangrene on the feet by diabetics with a deproteinized extract of veal blood (author's transl)].

1982 Feb;128(2):57-9. [Treatment of gangrene of the lower extremities in diabetics].

The authors believe that the main criterion for choice of the method of treatment of diabetic patients with gangrene of lower extremities is the degree of compensation of blood circulation which was estimated by temperature asymmetry of necrosis on the crus. The conclusion is made on the basis of treatment of 62 patients. The amputation at the femur level is indicated in decompensated blood circulation, amputations on the foot associated with intensive pharmacotherapy are indicated in subcompensation. Complex conservative treatment is possible in patients with a starting gangrene.