Factors associated with bone regrowth following diabetes-related partial amputation of the foot

Concomitants of Diabetic Foot Ulcer - A Review

BACKGROUND

Diabetes mellitus leading to foot ulcer is a serious complication, and it is considered a global epidemic. Neuropathyand high blood glucose levels are the primary causes of foot ulcers. Fifteen percent of people with diabetes develop foot ulcers, and these foot disorders are the main cause of lower extremity amputation among such patients.

INTRODUCTION

Complications of diabetic foot, affecting the lower extremities are common and quite complex and life-threatening. This review focuses on the life-threatening factors associated with diabetic foot ulcers and also the diagnosing and preventive measures. Neuropathy assessment and the range of foot ulcers were accurately examined.

CONCLUSION

Novel therapies focusing on the vascularity of the lower limbs, infection control, and ischemic control are being developed to mainly treat nonhealing ulcers.

Osteoclasis for the Treatment of Recalcitrant Diabetic Forefoot Ulceration: A Case Study

Recurrence after diabetic foot ulceration is a common occurrence after healing. Curative surgery has been suggested to reduce the incidence of recurrent ulcerations. Osteoclasis is a simple procedure used to fracture the metatarsal head in attempt to reduce pressure under the affected metatarsal without transferring excessive pressure to adjacent metatarsals. We present a case study of a 65-year-old diabetic male with multiple attempts to heal and maintain a healed ulceration who underwent an osteoclasis procedure. Following this patient for 3 years (until time of death), no recurrent or new ulcerations had occurred. Further studies should be conducted to identify if this result is reproducible prior to widespread use.

Transmetatarsal amputations

Transmetatarsal amputation is an excellent procedure in the face of nonhealing ulceration, infection, trauma, peripheral vascular disease, and tumors. This article discusses transmetatarsal amputations, the decision-making process, timing of surgery, operative techniques, postoperative management, and salvage of the failed transmetatarsal amputation.

Optimal waiting period for foot salvage surgery following limb revascularization

It is not clear how soon after bypass surgery tissue perfusion in the ischemic foot is adequate for healing. The purpose of this study was to determine the time interval for tissue to receive adequate oxygenation for healing following limb revascularization. Eleven patients with severe foot ischemia as defined by a transcutaneous oxygen tension (TcPO2) of 30 mm Hg or less were included in the study. TcPO2 measurements were performed prior to the lower extremity bypass and at postoperative day 1, 2, and 3. The mean preoperative value (9.27 mm Hg) was compared with the mean value at postoperative day 1 (17.73 mm Hg), postoperative day 2 (20.36 mm Hg), and postoperative day 3 (36.82 mm Hg) using paired samples t-tests. Statistically significant differences were observed between the mean preoperative TcPO2 measurement and the mean TcPO2 measurement taken on the 3rd postoperative day. The mean TcPO2 level increased from 9.27 mm Hg preoperatively to 36.82 mm Hg by the 3rd postoperative day (p = .001). There was also a statistically significant difference between the mean values on the 2nd (20.36 mm Hg) and 3rd postoperative day (36.82 mm Hg) (p = .002). Despite this finding, 5 of the 11 patients still had individual TcPO2 readings of less than 30 mm Hg on the 3rd postoperative day. Therefore, it can be concluded that in most instances tissue oxygenation reaches an adequate level after waiting at least 3 days following a bypass. Waiting 3 or more days could give adequate time for tissue reperfusion to promote healing of the surgical site.