The surgical treatment of diabetic foot ulcers

Diabetic foot ulcers usually appear in diabetic patients, being associated with neuropathy, peripheral arterial disease and infection. The treatment should be initialized after stabilizing the patients in terms of glycaemia, nutritional status and systemic infections. The local treatment is started with the surgical debridement and the defect is then closed by secondary intention or by using a skin graft or local flaps. A multidisciplinary approach and proper treatment prevent in some cases complications and avoid leg amputation, thus increasing the patient’s quality of life.

Amputation might be an option to the treatment when necrosis or osteomyelitis are present. On a long term, complications can arise due to the modification of the normal tension forces of the leg, with new ulcerative lesions or stress fractures. The long-term goal is to prevent injury to the affected or contralateral leg by maintaining health and glucose blood levels within normal limits and to instruct patients to maintain a proper feet care.