HEALING OF FOOT ULCERS IN IMMUNOSUPPRESSED RENAL-TRANSPLANT PATIENTS

Sixteen renal transplant patients were retrospectively studied to dete rmine the time foot ulcerations healed. All patients were taking imura n and medrol. More recently, patients were also on cyclosporine. All w ere insulin-dependent diabetics. A control group was established from a pool of randomly selected, age-matched, insulin-dependent diabetics who were also observed for foot ulcerations. All treatment was given b y one physician. Pulse volume recordings were obtained in all but eigh t patients, who were clinically believed to have normal vascular suppl y to the affected extremity. No statistically significant difference w as found between these groups in this regard. Cultures were obtained i n all patients when indicated; appropriate antibiotics were started. N o major differences were noted with respect to infecting organism. The immunosuppressed group had no excellent results, and three good, 14 f air, and 23 poor results. The control group had ten excellent, 14 good , 11 fair, and 17 poor results. A higher failure rate may occur with l imb-salvage surgery in the immunosuppressed patient. This observation confirms a long-held clinical suspicion.