Most of diabetic gangrene occurred in the elderly; male than female, male to female ratio is 3:2; course of the disease an average of about 10 years, parts of lower limb gangrene more common. The characteristics of diabetic gangrene
Most of diabetic gangrene occurred in the elderly; male than female, male to female ratio is 3:2; Cho scorpion? / A> course of the disease an average of about 10 years, parts of lower limb gangrene more common, accounting for 92.5%, upper limb rare, about accounted for 7.5%; unilateral incidence of about 80%, bilateral disease at the same time about 20%; toe and gangrene of the foot at the same time more common, accounting for 77.5%; toe and calf at the same time, 5% gangrene, leg gangrene accounted for only a 5%; toes or fingers disease accounted for 12.5%.
Clinical types of dry gangrene, wet gangrene, gangrene three kinds of hybrid.
(1) wet gangrene. Acral surface erosion of local soft tissue to form a shallow ulcer, followed by ulceration in-depth muscle, rather then the rotten broken tendon, bone damage, a large number of tissue necrosis, the formation of large abscess, and expel more secretions. This type of gangrene more common, accounting for 72.5%, mainly based on pathological microvascular basement membrane thickening due to microcirculation.
(2) Dry gangrene. Peripheral involvement acral necrosis, withered and black, lesion boundaries clear, to a certain stage of development will be handled on their own without falling. This type of gangrene or about 7.5%, the main pathological basis of the medium and small artery occlusion caused by avascular necrosis.
(3) mixed gangrene. About 20%. Microcirculation and small-artery occlusion exist two types of lesions, both extremities of the ischemic necrosis of dry, another foot, and (or) of the wet gangrene leg.
Classification of diabetic gangrene
0: No open lesions, clearly insufficient blood supply.
Grade Ⅰ: superficial ulcer. Blisters or other damage can be caused by, or arise spontaneously.
Grade Ⅱ: ulcer depth of tendons, ligaments, bones and joints.
Grade Ⅲ: deep ulcer infection and abscess with osteomyelitis and sinus formation.
Grade Ⅳ: There are toe and and (or) of the foot gangrene.
Ⅴ grade: All foot gangrene, which normally takes amputation.
The treatment of diabetic gangrene
(1) using diet control and drug treatment, strict control of diabetes, so that near-normal blood glucose levels, and to avoid the occurrence of low blood sugar.
(2) local surgical treatment. Gangrene, debridement and wrap it with antibacterial drugs and improving microcirculation.
(3) anticoagulation therapy. Dipyridamole, aspirin, Chinese medicine blood stasis agent.
(4) improvement of microcirculation. Anisodamine applications.
(5) antibiotic therapy. According to the results of bacterial culture and drug susceptibility tests use the appropriate antibiotics.
(6) other therapies. Given neurotrophic agent, are deficient in zinc, high-pressure oxygen therapy.
(7) cut-off toe, and (or) amputation.
(8) arterial reconstruction surgery.
