Author(s): Alzahrani H, Bedir Y, AlHayani A
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Abstract OBJECTIVE: To determine the effects of applying a natural polymer solution (shellac) to dry gangrene, and thereby prevent infection and progression to wet gangrene, in diabetic patients. METHODS: This randomized, controlled, pilot study included patients with type 2 diabetes mellitus who had unreconstructable peripheral vascular disease and were awaiting autoamputation. Eligible patients were contraindicated for surgery, had a limited life expectancy and/or had refused surgical amputations. All patients received the best possible medical treatment and were randomized to receive either topical shellac or antiseptic application of 10\% povidone-iodine (PVP-I) solution to gangrenous areas. RESULTS: A total of 26 diabetic patients were eligible for inclusion, of whom 23 completed the study: 13 were treated with shellac and 10 with PVP-I. The amputation rate was higher in the conventional treatment group versus the shellac group (60.0\% versus 46.2\%, respectively), although this difference was not statistically significant. CONCLUSIONS: Shellac is a natural solution that may be used to embalm gangrenous tissue in selected diabetic patients. More studies are needed to assess the long-term outcomes of this technique.
This article was published in J Int Med Res
and referenced in Journal of Diabetes & Metabolism