title: Symmetrical peripheral gangrene and the use of systemic hyperbaric oxygen therapy.
abstract: Symmetrical peripheral gangrene (SPG) is a rare but devastating condition when two or more distal sites become gangrenous, as the result of severe illness and treatment in critical care. The striking factor in SPG is that there is no occlusion of the major blood vessels to the affected limbs; the pathogenesis of the condition is not well understood and there are high reported mortality and amputation rates. Here we report the chronological progress report of a case of SPG, which affected both forefeet. This case report supports the view that early amputation should be avoided allowing for stabilisation of the gangrene so that no viable tissue is sacrificed. Further research is necessary to establish the pathogenesis and suitable treatment pathways.
authors.affiliation: Department of Podiatry and Foot Health, Newton Abbot Hospital, Newton Abbot, Devon, UK. su.stewart@nhs.net
authors.forename: S
authors.initials: S
authors.lastname: Stewart
mesh_terms: D000673:Amputation, Traumatic; D018450:Disease Progression; D005734:Gangrene / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000009:adverse effects; D014034:Toes / Q000098:blood supply / Q000473:pathology*; D014662:Vasoconstrictor Agents / Q000009:adverse effects
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine