Abstract
Success in management of peripheral gangrene in the aged should be measured not by operative mortality but by the incidence of return to useful activity. Wider use of amputations which conserve a useful foot, or a useful knee joint, is strongly advocated. Prophylactic principles are outlined as well as the principles of definitive treatment of gangrenous lesions by conservative technics. Diligence and care will be rewarded by a success rate high enough to support wider use of conservative management.