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How long will it take to heal gangrene of a diabetic patient ?

Please can i get more light on this? My last post was about my dad having edema and an ulcer wound , and i got responses that he needed medical attention. So we took him to the hospital and he was confirmed to have gangrene. Now the right big toe was cut off and the wound still wont heal. But the swollen leg has reduced to the feet level. We are asked to do a color doppler, we did and it came back normal. And honey is being used in the hospital to treat the wound daily. So i want to ask, how long could it take to heal fully? and why is the second toe looking dark colored when the color doppler says the limb is normal? Pls help, i will post pictures later.
Asked On : Fri, 11 Nov 2011
Answers:  4 Views:  394
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  Anonymous's Response
Hi. You should understand that a Doppler study would detect blood flow only in the large blood vessels and not in the micro-circulation (smaller capillary blood vessels). There are no completely reliable tests to detect blood flow in the micro-circulation. In long standing uncontrolled diabetes, you should expect problems in the micro-circulation. That explains the impending gangrene in the second toe. Take Care.
Answered: Wed, 16 Nov 2011
General & Family Physician Dr. K. P. V. Rao's  Response
Strict control of your dads blood sugar level alongwith proper wound dressing and strong antibiotics will help the wound heal faster.I guess he is on Insulin--so give injections on time and with correct dose.Alternately, check for antibiotic culture sensivity of disharge from the wound to help you give the best possible antibiotic.
Answered: Sun, 20 Nov 2011
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Hello.Welcome to HCM forum.Diabetic foot ulcers are very dicey and unpredictable.Inspite of normal color Doppler you still can have ischemia because of microvascular ischemia.Most important things are normoglycemia and very good antibiotic cover.I will not be surprised if the surgeon takes the decision for amputation unto ankle to save the limb.Thanks and good luck.
Answered: Sun, 20 Nov 2011
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General & Family Physician Dr. Rajath. Pejaver's  Response
Hi , thanks for your query.
Wounds tend to take longer to heal in diabetics.Strict control of blood sugars will help, along with regular dressing and antibiotics. Doppler checks the blood flow in the larger blood vessels.This was done to check for for sluggish blood flow which will hamper wound healing.It is difficult to predict when it will heal completely, usually 4-5 weeks.
Thank you. Have a healthy life.
Answered: Fri, 11 Nov 2011
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