Diabetic foot gangrene varies in nature and severity depending on the emphasis and priority of arterial obstruction and microvascular disease, and can be divided into several types: classified by vascular disease, it is divided into microvascular disease gangrene and large vessel disease gangrene; according to the nature of the gangrene, it is divided into wet gangrene, dry gangrene, and mixed gangrene.
**What is Microvascular Disease Gangrene?**
Diabetic foot microvascular disease gangrene is the most common clinically. Its pathological changes include mild lesions in medium and small arteries of the limbs, severe microvascular disease and microvascular obstruction in the feet, with palpable dorsalis pedis and posterior tibial artery pulses. Ulcers and gangrene often occur due to malnutrition of the skin, trauma, dry cracked skin, and infection. It can appear at any location on the foot, with varying depths. Severe infections may induce extensive gangrene.
**What is Large Vessel Disease Gangrene?**
Diabetic foot large vessel disease gangrene is caused by lesions in the medium and small arteries of the limbs. The pathological change is due to the occlusion of larger arterial trunks, leading to severe limb ischemia, similar to arteriosclerotic occlusive disease, often accompanied by extensive gangrene and secondary infection.
**What is Wet Gangrene?**
Diabetic foot wet gangrene accounts for 72.5%—76.6% of diabetic gangrene cases and is a major cause of disability in diabetic patients. It manifests as erosion of local tissue skin at the distal part of the limb, initially forming ulcers that progress to deeper muscle layers, even reaching tendons and destroying bone, leading to massive necrosis and corruption of tissues, forming abscess cavities with copious secretions. Surrounding tissues exhibit redness, swelling, heat, and pain. Its pathological basis is diabetic microvascular disease and sclerosis of medium and small arteries.
**What is Dry Gangrene?**
Diabetic foot dry gangrene accounts for approximately 5.9%—7.5% of diabetic gangrene cases. It manifests as delayed or absent sensation at the extremities of the affected limb, with dark brown skin. As necrosis progresses, local skin, muscles, and tendons become dried, blackened, mummified, and may even fall off spontaneously. There is a clear boundary between the lesion and healthy skin, usually without secretions or edema at the extremities. The main pathological basis is the gradual interruption of blood flow during the occlusion process of medium and small arteries in the limbs, leading to tissue dehydration and drying without infection.
**What is Mixed Gangrene?**
When clinical features of both wet and dry gangrene coexist, it is referred to as mixed gangrene. This includes both ischemic dry necrosis at the extremities and wet gangrene in areas such as the dorsum of the foot, sole, and lower leg. Mixed gangrene accounts for 18%—20% of diabetic gangrene cases. Its pathological basis is the concurrent existence of microcirculation disorders and small artery obstruction, compounded by infection.
The classification and symptoms of diabetic foot gangrene have been introduced above, including the characteristics of symptoms of microvascular disease gangrene, large vessel disease gangrene, wet gangrene, dry gangrene, and mixed gangrene. We hope this helps you. For more questions, you can consult online with experts from Shanxi Yikang Peripheral Vascular Hospital. Finally, we wish you good health.
For more details, please visit the diabetic foot section of Shanxi Yikang Peripheral Vascular Hospital: http://www.sxykmgy.com/tangniaobingzu/ or consult experts for free. Experts will provide detailed answers based on the specific conditions of the patient.
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