• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.32-37
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• 2018

Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.216-220
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• 2007

Purpose: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene. Materials and Methods: Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation. Results: Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement. Conclusion: As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.

• Physical Therapy Korea
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• v.5 no.2
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• pp.98-105
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• 1998

The purposes of this article are to review the pathogenesis, prevention, and management of amputation due to diabetes mel1itus complications, and to report one case who had lost his toes due to diabetes mellitus. A primary cause for hospital admission of the patient was foot ulcer. Since many amputations in diabetic patients are precipitated by such ulcers, a program for active prevention and optimal treatment of diabetic foot lesions might decrease the risk of amputation. Diabetic foot ulcers and, ultimately, amputation can stem from a variety of pathways. The combination of peripheral neuropathy, peripheral vascular disease and infections is the harbinger of the final cataclysmic events of gangrene and amputation. As the physical therapist is often involved in the treatment of diabetic patients, the therapist should be aware of the followings: the patient's type of diabetes and the severity of the diabetes, the complications of the disease, the effects of exercise, the importance of wearing proper shoes and education to patients about appropriate diabetic foot care.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.187-191
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• 2022

The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

• Journal of Sasang Constitutional Medicine
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• v.16 no.3
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• pp.129-132
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• 2004

1. Objectives Besides Diabetes Mellitus, its complications are matter of concerns as well. Its following complications are cardiovascular disease, glomerulopathy, retinopathy, neuropathy and diabetic gangrene. These complications can cause overall damage in major organs. In traditional oriental medicine it has been perceived that gangrene is mainly caused by "hwa(火)" but under sasang constitutional medicine its has been diagnosed as Taeumin superficial-disease(太陰人 表病) and Taeumin Jowiseungchung-tang(調胃升淸湯) was prescribed. As a result, significal improvments was noted and thefore we report the outcome. 2. Methods We have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to a patient for treating diabetes complications. 3. Results This patient was treated with Sasang Constitional Medicine and acupuncture for about three weeks. After treatment, ulcer and whole body edema were improved considerbly. 4. Conclusions We have dianosed the patient as Taeumin superficial-disease(太陰人 表病) by undergoing several diagnostic method used in sasang constutional medicine. Therefore we have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to the patient and has obtained satisfactory results in curing several diabetic complications especially ulcer due to diabetes.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.26-30
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• 2005

Purpose: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. Materials and Methods: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). Results: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. Conclusion: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.1-6
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• 2006

Purpose: To evaluate the clinical manifestations, the patterns and the functional outcome of the amputations due to the diabetic foot complications. Materials and Methods: Fifty patients (50 feet) of diabetic foot amputations were followed for more than 1 year. The mean age was 62.5 years, and the mean follow-up period was 46 months. Retrospective analysis was performed using chart review and interview with the patients. The outcome was assessed with modified AOFAS scale. Results: The diabetic foot lesions were infection in 45 feet, gangrene in 35 feet and ulcer in 15 feet. Toe amputation was most commonly performed procedure (23 cases) followed by below knee and ray amputation. Postoperative modified AOFAS score was average 51.5 points, and 94% were satisfied with outcome. Minor amputations showed better outcome than the major amputations. Conclusion: Overall postoperative functional outcome was encouraging with high patient satisfaction rate (94%). Better outcome was obtained with the minor amputations.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.148-150
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• 2022

Myiasis is the parasitic infestation of the body of a live animal by fly larvae that grow inside the host while feeding on its tissue. Necrotic tissue is a favorable environment for larvae to thrive, which can be seen easily in patients with a diabetic foot. Myiasis in a diabetic foot is rare but is constantly being reported. The common larvae genera causing myiasis are Calliphoridae, Sarcophagidae, and Muscidae. This paper reports a rare case of sarcophaga myiasis in a diabetic foot. To the best of the author's knowledge, this is the first case report in Korea regarding human myiasis with the sarcophaga genus.