Necrosis following acute ischaemia

A 74-year-old lady with type 2 diabetes of 32 years' duration, developed acute ischaemia of her right leg (Fig. 6.6a). Postoperatively she developed blistering on the dorsum of the foot and discolouration of the tips of three toes, but the foot was well perfused and the graft was patent (Fig. 6.6b-d). She was treated conservatively with systemic antibiotics to control and eradicate infection and gentle debridement of the demarcation lines between gangrene and viable tissue. She had regular graft surveillance. After 7 months the necrotic areas autoamputated and the foot healed.


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