Awaiting Autoamputation: A Primary Management Strategy for Toe Gangrene in Diabetic Foot Disease

We have offered subjects with diabetes and toe gangrene in whom initial antibiotic treatment of associated infection has resulted in a well-demarcated, dry gangrenous digit, the choice of surgical amputation or awaiting autoamputation. We performed a retrospective cohort study to assess the effectiveness of the strategy of awaiting autoamputation by assessing subjects presenting to the multidisciplinary diabetes foot clinic between February 2007 and February 2010 in whom this was the primary management strategy. Mann-Whitney and Fisher exact tests were used for comparisons between groups. We identified 11 such subjects: 7 (64%) were male, 4 (36%) had type 1 diabetes, and median (interquartile range) HbA1c was 8.3% (8.1–8.7). Age and duration of diabetes were bimodally distributed: 41.5 (38.5–48) and 34 (32.5 …