“Slippers Gangrene”: A Unique Case of Symmetrical Peripheral Gangrene
A recent case report by Babajide Ogunlana, DPM, published on the HMP Global Learning Network, details an unusual presentation of symmetrical peripheral gangrene (SPG) in a non-diabetic patient following critical illness. The case highlights the importance of early recognition, biologic wound therapies, and strategic surgical intervention in limb preservation.
Case Overview:
- Patient Profile: A 46-year-old male developed bilateral “slippers”-shaped dry and wet gangrene of the forefeet after an ICU stay that included vasopressor therapy for septicemia and aortic dissection repair.
- Surgical Management: The right foot underwent transmetatarsal amputation (TMA), while the left foot was treated with extensive debridement and multiple xenograft applications to preserve limb function.
- Wound Strategy: Silver-impregnated dressings and biologic matrix scaffolds were used instead of negative pressure therapy, facilitating tissue regeneration and exudate control over an extended period.
- Outcomes: The right foot healed within 12 weeks; the left foot’s plantar wound closed after over a year of consistent follow-up and graft reapplication. Both limbs were ultimately salvaged.
This case demonstrates the potential for successful limb salvage even in high-risk, non-diabetic patients with vasopressor-induced ischemia, when advanced wound care techniques and aggressive follow-up are applied.
Keywords:
Babajide Ogunlana,
symmetrical peripheral gangrene,
transmetatarsal amputation,
xenograft wound matrix,
silver dressings,
limb salvage,
vasopressor ischemia