Abstract
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 [1]) and diabetic neuropathy, causing sensory nerve disturbance (as happens in the cases where shoes and thermal injuries are involved) and autonomic nerve disturbance [2]. 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.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Strandness DE, Pruest RE, Gibbons GE (1964) Combined clinical and pathologic study of diabetic and nondiabetic peripheral arterial disease. Diabetes 13: 366–372
Grover-Johnson NM, Baumann FG, Imparato AM, Kim GE, Thomas PK (1981) Abnormal innervation of lower limb epineurial arterioles. Diabetologia 20: 31–38
Rhodes BA, Greyson ND, Siegel ME, Giargiana FA (1973) The distribution of radioactive microspheres in patients with peripheral vascular disease. Am J Roentgenol Radiother Nucl Med 118: 820–826
Spence RJ, Rhocles BA, Wagner HN (1972) Regulation of arteriovenous anastomotic and capillary blood flow in the dog leg. Am J Physiol 222: 326–332
Lassen NA, Lindjerg IF, Munck O (1964) Measurement of blood through skeletal muscle by intramuscular injection of xenon-133. Lancet I: 686–689
Yamakoski K, Shimazu H, Togawa T, Ito H (1978) Admittance plethysmography for accurate measurement of human limb blood flow. Am J Physiol 235: 821–829
Kawakami K, Katuyama N, Mori Y, Shimada T, Tamura T, Togawa T, Shimazu H, Yamakoshi K, Fukuoka M, Ito H, Fujisaki N (1981) A combined study of admittance plethysmography and radionuclide methods for measurement of peripheral circulation. In: Proceedings of the ICEBI, Tokyo 1981. Japanese Society of Medical Electronics and Biological Engineering, Tokyo, pp 333–336
Zanick DC, Delaney JP (1973) Temperature influences on arteriovenous anastomoses. Proc Soc Exp Biol Med 144: 616–620
Hales JRS, Iriki M (1975) Integrated changes in regional circulatory activity evoked spinal cord and peripheral thermoreceptor stimulation. Brain Res. 87: 267–279
Deleaney J, Scarpino J (1973) Limb arteriovenous shunting following sympathetic denervation. Surgery 73: 202–206
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag Tokyo
About this chapter
Cite this chapter
Isogai, Y., Saito, N., Shimada, T., Tanaka, S., Ito, H. (1988). Microcirculation in Diabetic Gangrene. In: Manabe, H., Zweifach, B.W., Messmer, K. (eds) Microcirculation in Circulatory Disorders. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68078-9_55
Download citation
DOI: https://doi.org/10.1007/978-4-431-68078-9_55
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-68080-2
Online ISBN: 978-4-431-68078-9
eBook Packages: Springer Book Archive