Dry gangrene diabetic patient


Q: Dry Gangrene evident on foot thumb of diabetic patient suffering a renal failure and has been on dialysis for the past several years.
Age: 75 years / female.
Is hyperbaric oxyegen therapy of any use?

Symptoms:  Black foot thumb

A:   Hello,
Thank you for your medical query at AskTheDoctor.com
I understand your concern.
The efficacy of the HBOT depends completely on the severity of the gangrene. If there are small patches of black with normal skin in between, methods such as revascularization or HBOT can still be helpful.
However, once the gangrene sets in, and the entire skin or the toe turns black, there is no point in doing either HBOT or revascularisation. Black areas indicate that the whole area is already dead devoid of any blood flow, and even with renewed blood flow, this tissue is not viable.

Considering her medical history, it does not seem probable that she will respond well to such therapies.

You can still talk to her treating physician, if the whole toe is not black, and there are patches of normal skin, you can still go ahead and try HBOT.

Hope this was helpful,
Feel free to discuss further,

Comments / Follow Ups

Patient: The whole toe is black.
Is amputation the only viable remedy?
some alternative medical practitioners claim success with leech therapy.
what would you recommend?
Doctor: Hello,
No, leech therapy is not going to be effective.
Since the whole toe has turned black, unfortunately, amputation is the only remedy.


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