Forefoot perfusion pressure and minor amputation for gangrene.

Abstract

In many cases of digital gangrene, limited amputation to preserve the majority of the foot is possible. In the absence of invasive infection, forefoot perfusion pressure is the single most important factor in determining outcome of minor amputation. At ankle pressures of less than 35 mm. Hg, salvage of the foot appears to be futile. The presence or absence of diabetes mellitus has no noticeable effect on the result of amputation. Ankle systolic pressure measurement cannot supplant but should supplement clinical judgement in selecting surgical treatment for gangrene.