Microcirculation in Diabetic Gangrene
One of the major complications of diabetes mellitus is diabetic gangrene, which has been increasingly observed in recent years. It is very specific in its features in that: (a) the peripheral pulsation remains intact, (b) the skin temperature is high, (c) the gangrene is wet, and (d) sensory nerve disturbance is present. It is often caused by friction from shoes or by thermal wounds and has a tendency to relapse. The many reports on this complication indicate that the probable etiology of the gangrene is diabetic micro angiopathy (though there are reports that the degree of microangiopathy makes no difference in the presence of the gangrene ) and diabetic neuropathy, causing sensory nerve disturbance (as happens in the cases where shoes and thermal injuries are involved) and autonomic nerve disturbance . The latter results in the inability to control vascular tone in the peripheral circulation. However, there has been insufficient explanation as to why this type of gangrene relapses so often.
KeywordsSkin Blood Flow Shunt Flow Blood Flow Distribution Arteriovenous Anastomosis Shunt Rate
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