Gangrene In Diabetes

Gangrene of the lower extremities without amputation

Depending on the severity of the gangrenous lesion of the limb, the surgeon who has the patient observes conducts a primary examination of the legs, and then determines a set of delivery tests, providing an opportunity for detailed study of the patient’s health.

 Based on this information, a course of treatment is already formed, consisting of strong antibiotics that suppress the activity of pathogenic microflora that caused soft tissue necrosis of the legs, solutions that eliminate the toxic effect of exotoxins caused by infection, and blood transfusions if necessary. 

This procedure is indicated in cases where there is a real risk of blood poisoning or the first signs of complications of the current disease have already been noted. Even if the surgeon decides not to perform an amputation and save the patient’s limb at all costs, in this case, you still have to resort to surgical tissue rehabilitation by cutting necrotic fragments. Treatment is lengthy and complex, requiring endurance from the patient and a lot of physician experience.

How many live with gangrene without amputation of the lower extremities?

Life expectancy with gangrene of the legs largely depends on the type of necrosis. If it is a dry type of gangrenous tissue destruction, then the patient can live 10 to 20 days, and patients with a strong heart, immune system, and well-functioning kidneys have shown a longer lifespan of the body. The fact is that the quality of such a life is critical and that a sick person, if he does not receive painkillers from the category of narcotics, simply suffers from severe pain, which can often cause shock and the onset of heart failure.

The wet variety of gangrene develops even faster and without intensive drug therapy leaves the patient no chance of recovery. In this case, the person will be able to live without amputation for longer than 10 days.

 During this period, the pathogenic microflora in the soft tissues of the limbs will reach its peak in population growth, meat decay will become so dynamic that the patient's body simply cannot cope with such a volume of toxins, the kidneys will no longer be able to cope with blood purification function and be deadly. The only difference is that if dry gangrene pain syndrome is present but not so acute, then the wet type of gangrene is even more painful.

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Life with necrosis of the lower extremities is possible only if the person has responded responsibly to their health, or is a doctor and is well acquainted with the symptoms of the manifestation of this disease. He did not hesitate at the first signs of the disease and immediately turned to a surgeon for medical help, and the doctor immediately began therapy for the area of ​​potential necrosis. 

Only in such a situation is it really possible to live with gangrene, its effective treatment and curbing the progression of the disease, preventing the pathogenic infection from affecting large parts of the legs, and completing the disintegration of the tissue by cutting off the limbs. Despite all the efforts of the medical staff, even in this case, an individual choice of powerful drugs and long-term therapeutic treatment will be required.

Can gangrene be cured without amputation and how?

It is indeed possible to get rid of gangrene, regardless of its nature and variety, but according to statistics, no more than 23% of patients can fully recover from this disease without losing their legs.

 This is a very low indicator of a favorable prognosis, and the success of therapy has mostly been recorded in large medical centers and hospitals equipped with new diagnostic equipment, and there are real professionals in their field in the staff of the health institution.

 On the periphery in small regional centers, gangrene treatment indices without amputation are an order of magnitude lower, and in most cases, doctors choose to amputate the leg even in the early stages of necrosis, so as not to risk the patient’s life again.

Let us consider in more detail, with the help of which drugs and therapies, it is possible to cure gangrene of the lower extremities without the use of amputation, and we will also study the testimonies of patients who used these treatment options and were able to overcome serious infectious disease.

Vascular surgery

This method of treating gangrene is used if the disease is caused by blockage of the main blood vessels, which prevents blood from entering the segments of the lower extremities with the onset of dry or wet necrosis. In that case, the surgeon performs a tape operation, inserts a shunt into a thrombosed vessel, and performs a bypass operation, which cleans the vein or artery from a blood clot that interferes with stable blood circulation.

After eliminating the pathological cause of the disease, the lower parts of the legs regain blood circulation and the process of cell death ceases.

Stabilization of blood glucose

Gangrene is thought to develop in 15% of cases due to the fact that people suffer from type 1 diabetes and are unaware that they have a pancreatic disease. In this sense, excessive levels of blood sugar crystals methodically clog the smallest capillaries of blood vessels, which becomes the cause of gangrene. 

To avoid amputation and eliminate the pathological factor that contributes to the development of the disease, the surgeon in close collaboration with the endocrinologist selects the required dose of insulin for the patient to maintain optimal blood glucose levels. As soon as this cause is resolved, the patient recovers immediately and the wound on the limb gradually heals.

Intensive antibiotic therapy

In those clinical situations where a person turns to the clinic for help in the early stages, a great way to treat gangrene without resorting to a limb clip is to give the patient a course of broad-spectrum antibacterial drugs. 

The drug is selected individually based on the type of microbes that have penetrated the wound surface and caused such an acute inflammatory process with signs of tissue fertilization, as well as their cadaveric decomposition. In a mixed type of infection, when two or more strains of bacteria are diagnosed at the same time, combination treatment and the introduction of several types of antibiotics are performed.

Cutting light bulbs

There is a type of bacterial infection such as clostridia, which live in the soil and, if they enter the human body through the surface of the wound, penetrate deep tissues where there is no access to air. After that, the process of rotting the meat with signs of necrosis begins. 

As soon as oxygen access reaches the pathological site of clostridia accumulation, the pathogenic microflora dies immediately, the load on the immune system is reduced several times, and the patient can recover not only through medical therapy but also due to vital resources of his own body.

To do this, the surgeon performs cutting the bulb around the inflamed limb in the operating room, removes wounds, removes necrotic tissue, and then places drainage so that all purulent exudate and ichorous form in the process of disintegration of limbs into a special container and do not accumulate in the diseased body. poisoning him. It is an effective method of treatment, but it carries a risk for the patient's life and there is a great danger that a secondary infection will get into the wound of the lamp, and then amputation will not be avoided.

Local antibiotic therapy

This is another effective way to treat gangrenous necrosis of limb tissue without the use of amputation. To achieve this, the patient is given antibiotics not intramuscularly or intravenously, as is usually the case with the formation of a general therapeutic course, and the patient receives injections into the subcutaneous tissue directly around the site of gangrene development. This method is recommended to be used if there are no signs of tissue decompression on the affected leg.

Also, topical application of antibiotics allows you to stop the progression of the line of demarcation, which separates the diseased part of the leg from the healthy ones. Antibacterial agents such as Bieselin, Erythromycin, Biodroxyl, Rizolin, Sporidex are most often used in treatment.

 Patients who have undergone gangrene therapy using this method notice that the method really helps reduce the progression of necrosis, but injecting directly into the affected leg causes very severe pain. We recommend reading about the development of Fournier sexual gangrene.

Ointments and creams

A special group of drugs that are included in a complex treatment regimen and allow physicians to save a patient’s limbs, avoiding the need for surgical removal. The principle of treatment is to apply an even layer of antiseptic, anti-inflammatory, and healing ointment on the skin of the affected gangrene, whose active ingredients penetrate through the thick epithelial layer and reach the very center of the inflammatory process. Most drugs in this group belong to antibacterial drugs, but they are created only on the basis of ointments.

The most effective are creams and ointments such as tetracycline, chloramphenicol, clindamycin, levomenthol, gentamicin, erythromycin. The frequency of treatment of the legs affected by necrosis is saturated and is carried out every 3-4 hours during the day. 

Such a density of therapeutic manipulations will maximize the nourishment of the affected tissues of the lower extremity and significantly reduce the inflammatory process, suppress the growth of bacterial microflora, and stimulate the healing process of soft tissues destroyed by gangrene.

Patients who use creams and ointments to treat necrotic processes in the foot react positively to this type of drug, because the effect of its application is very high, and painful feelings during procedural moments are completely absent.

Antiseptic solutions

Liquid preparations contain a certain percentage of the antibacterial component, which locally acts on the purulent microorganisms that cause the progression of gangrene. 

To avoid amputation, the patient is prescribed to wipe the formation of wounds and the surface of the foot that has changed color with solutions such as chlorhexidine with 3 or 16% concentration, Furacillin, Miramistin, hydrogen peroxide, and potassium permanganate (prepared on the basis that medical staff or patient myself if at home, dissolve 2-3 crystals of potassium permanganate in 1 liter of warm water). 

Patients who have a wet form of gangrene in the presence of open ulcerative formations show not only to wipe the limb but also to wash the inflamed tissues. 

Reviews of this type of therapeutic method of treatment can be classified as positive since the severity of the inflammatory process decreases as early as 2-3 days after the start of treatment. Familiarize yourself with the indications for amputation in gangrene.

This is a separate category of gangrene treatment methods, so no surgical removal of the extremities is performed. To do this, use medicinal decoctions of leaves, stems, and flowers of medicinal herbs. They can be purchased ready-made in the form of a mixture or cooked yourself. Just buy a pack of dried chamomile, St. John’s wort, sage, horsetail, buckthorn, or thyme. Each of these plants has pronounced anti-inflammatory, antibacterial, and medicinal effects.

15 grams of plants of these species were thrown into a clean metal container, poured with 1 liter of running water, and cooked on medium heat for 15-20 minutes. During this period, all the useful and medicinal substances contained in medicinal herbs go into the water, and with their help, you can treat inflammatory processes in the tissues of the diseased leg. 

The resulting broth is added to the sink with warm water in a ratio of 1 liter of broth to 3 liters of plain water. The damaged limb was immersed in the therapeutic fluid and anti-inflammatory baths were made.

Recommended number of procedures - 3-4 times a day. It is important to observe the mandatory rule that the water in the tank was not hot, but it was warm and did not exceed a temperature of 38-40 degrees. 

Only then will a positive therapeutic effect be achieved. Patients who have been treated for gangrene with herbal infusions and have been able to avoid amputation claim that the method is really effective, but cannot be used as an independent method of therapy. It is better to include it in the overall treatment regimen.

Hormonal drugs

A special group of drugs, which are also used to treat gangrene, when there is a real opportunity to eliminate the inflammatory process, stop tissue decay and thus avoid amputation. These are drugs created on the basis of synthetic hormones, whose medicinal properties are the acceleration of metabolic processes and more intensive regeneration of tissue cells. Drug hormones have a similar effect on immune system cells.

Due to that, the resistance of the organism to the bacterial microflora, parasitizing in the lower extremity affected by necrosis, increases several times. The drug is considered really effective and allows you to get rid of gangrene without cutting off the limb, but it has a significant drawback, which consists in the presence of a large number of side effects that adversely affect the patient's hormonal background.

Also, serum ASD 2 and ASD 3 (antiseptic Dorog stimulator) are used in all phases of treatment of wet gangrene without amputation. The latter is intended for the external treatment of limbs, and the former type of medicine is used for swallowing. The dosage and duration of therapy are determined exclusively by the physician, as the drug has not yet fully passed all clinical trials.