Diabetic Foot Management

Diabetic foot infections are the leading cause of hospitalisation for diabetic patients worldwide and in developing countries like India it accounts for 20% of admissions in surgical wards.

Diabetic wounds are caused by a combination of neuropathy, ischemia and infection.

Accurate assessment and diagnosis of diabetic wounds is critical to effective management.

Surgical management :

• Wound dressing
• Incision and drainage
• Fasciotomy
• Wound debridement and skin cover
• Vascular reconstruction
• Amputations

Role of plastic surgeons is a multidisciplinary approach. Plastic surgeons bring on the capability to enhance healing by soft tissue manipulation, following a reconstruction algorithm to manage and salvage diabetic foot ulcers. Plastic surgeons may play a critical role in salvage of the limb as durable soft tissue coverage is essential.

Autologous skin grafts are one of the most commonly used methods to provide coverage by a plastic surgeon. The skin can be used as partial and thickness grafts and require a recipient bed that is well vascularized and free of bacterial contamination

Lower extremity complications remain most common reason for hospitalization in people with diabetes mellitus.

Soft tissue reconstruction by an experienced plastic surgery team can help preserve as much as residual limb as possible. In some case preservation of the foot may be possible avoiding a major amputation.

Dr. Darshansingh Rajput
Senior Consultant
MS, MCh