A CASE REPORT ON GANGRENE OF RIGHT FOURTH TOE
P. Naga Jyothi*, G. Sree Mahalakshmi and Dr. A. Sandeep
Gangrene is defined as focal or extensive necrosis of the skin and underlying tissue. However, this definition presents difficulties. There are several etiologies for gangrene, as there are for foot ulcers. One is LEAD (Lower Extremities Arterial Disease) of the large or small vessels, but infection and neuropathy may also play a role. Gangrene is better correlated with LEAD than is foot ulcer. The demonstration of clinical or subclinical LEAD is essential if gangrene is to be considered a manifestation of the progression of LEAD in the individual patient. The prevalence of gangrene is greater in selected diabetic patient populations than in the general community. However, prevalence is not a satisfactory indicator of the importance of gangrene in diabetes, compared with incidence, because of the poor survival experience of these patients and their consequent loss from the prevalent population. Risk factors for gangrene have not been adequately quantified for diabetic patients. They include LEAD, peripheral neuropathy, infection, trauma, and delayed healing. The grafting was done to reduce the spread of infection. Antibiotics like Amoxicillin + clavulanic acid and metronidazole along with some analgesics (Aceclofenac, tramadol) and anti-platelets like cilastazole for 2 weeks reduced the infection spread and may not lead to the further complications.
Keywords: LEAD, gangrene, grafting, Antibiotics, Analgesics.
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