Three main contributors to gangrene are: Diabetes, infection, and peripheral arterial disease. Unfortunately this patient’s gangrenous foot and ankle is ascending up her leg. This patient also has all three contributing causes of gangrene: Diabetes, infection and peripheral artery disease.

Education: Control blood glucose and hemoglobin A1C. Any sign of redness or swelling in a diabetic’s foot anywhere on the toes, part of the toenail, arch, heel, ankle or lower leg needs to examined within a day. The best doctor to see for these cases is the podiatrist.

Treatment: If blood glucose is too high, see family doctor or internist for prescription diabetic medication either pills or insulin or both. See an endocrinologist to control Hemoglobin A1C. Get oral or injectable antibiotics to control the bacteria. Have the ulcer or wound treated right away with topical medicine to help the healing and lower the bacterial count. Get a vascular ultrasound to see if there are blocked arteries or veins that can lead to tissue necrosis. A vascular surgeon or interventional radiologist can do endovascular procedures to unblock the blood vessels to get better blood flow to the foot and get better healing.

Together with education and prevention and the proper treatment, gangrene can be prevented and treated before it gets to this degree of disease.

Dr. Henry Tseng

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