Early signs of necrosis

The signs that part of a foot is becoming necrotic may be subtle in the early stages, and may mimic bruising or chilblains. A careful search should be made for early signs:

• A toe which is developing a blue or purple tinge, having been previously pink because of infection or ischaemia

• Toes which have become very pale in comparison with their fellows

• An ulcer which has changed its colour from healthy shiny pink granulations to grey, purple or black or its texture from a smooth to a matt surface (Fig. 6.1).

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