A diabetic male, 65 years old was referred to us at early May/ 2013 for vascular opinion regarding his left lower limb, he was complaining from infected left foot ulcer of 10 days duration. This ulcer was the result of gangrenous fifth toe amputation. The ulcer was wide extending from the base of fourth and fifth toes to about mid-foot and from dorsum to plantar surfaces with irregular margin, necrotic tissues, exposed gangrenous fifth metatarsal bone, and obvious, very offensive discharge