Diabetic foot amputations. Part I: Digital

Abstract

Foot lesions in diabetic patients with sensory deficiencies are ignored or not noted by the patients, therefore, leading to major infections of the soft tissue and/or bone. This can be quite devastating with subsequent loss of limb and life-threatening if the extent of the problem is not recognized and prompt treatment initiated. If an amputation is necessary, it should be performed at the lowest level possible. Part I of this series of articles, concerning diabetic foot amputations, will review the pathogenesis, indications, objective vascular criteria, basic surgical principles and complications of diabetic foot amputations. Case reports with various digital amputation procedures and their postoperative care will also be presented in detail. A team approach should be used in the treatment of diabetic foot disorders. The podiatrist, along with admitting internist, leads a team of other specialists including: radiologist, vascular surgeon, infectious disease physicians and plastic surgeon, depending on the progression of foot pathology.