Diabetic foot surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

One of the centerpieces of diabetic foot treatment is debridement of necrotic and fibrotic tissues as well as calluses. Debridement should be done until it reaches the bleeding tissue, which is both a treatment and a diagnostic method to evaluate ulcer margin and abscess‘s presence.

Surgery

One of the centerpieces of diabetic foot treatment is debridement of necrotic and fibrotic tissues as well as calluses.^[1]^[2]
Debridement should be done until it reaches the bleeding tissue, which is both a treatment and a diagnostic method to evaluate ulcer margin and abscess‘s presence.
Before any surgical procedures, perfusion of the involved limb must be checked, since proper perfusion is critical for healing.^[3]
Since proper perfusion is critical for wound healing, presence of any of the following is indicative for vascular intervention in diabetic foot:^[4]^[5]
- Ankle pressure less than 80 mmHg
- Toe pressure less than 55 mmHg

References

↑ American Diabetes Association (1999). “Consensus Development Conference on Diabetic Foot Wound Care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association”. Diabetes Care. 22 (8): 1354–60. doi:10.2337/diacare.22.8.1354. PMID 10480782.
↑ Armstrong DG, Lavery LA (1998). “Diabetic foot ulcers: prevention, diagnosis and classification”. Am Fam Physician. 57 (6): 1325–32, 1337–8. PMID 9531915.
↑ Schaper, N. C.; Andros, G.; Apelqvist, J.; Bakker, K.; Lammer, J.; Lepantalo, M.; Mills, J. L.; Reekers, J.; Shearman, C. P.; Zierler, R. E.; Hinchliffe, R. J. (2012). “Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot”. Diabetes/Metabolism Research and Reviews. 28: 218–224. doi:10.1002/dmrr.2255. ISSN 1520-7552.
↑ Lepäntalo, M.; Apelqvist, J.; Setacci, C.; Ricco, J.-B.; de Donato, G.; Becker, F.; Robert-Ebadi, H.; Cao, P.; Eckstein, H.H.; De Rango, P.; Diehm, N.; Schmidli, J.; Teraa, M.; Moll, F.L.; Dick, F.; Davies, A.H. (2011). “Chapter V: Diabetic Foot”. European Journal of Vascular and Endovascular Surgery. 42: S60–S74. doi:10.1016/S1078-5884(11)60012-9. ISSN 1078-5884.
↑ Raines JK, Darling RC, Buth J, Brewster DC, Austen WG (1976). “Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities”. Surgery. 79 (1): 21–9. PMID 1246689.

Overview