The Surgical Management of Diabetic Foot

Diabetes has proved itself a silent killer disease. Today in the world maximum numbers of the patients are suffering from this disease, and moreover they are passing through the associations of the complications too. In present study 50 cases of diabetic foot surgically managed has been studied at teaching institute in department of surgery. The limb was preserved in 35 out of 50 cases. 15 out of 50 cases despite of proper medical management and repeated debridement had to undergo local amputation-B\K amputationA/K amputation. This was done to save the patients. It is concluded that we should be able to save 100% limbs in diabetic foot and no amputations provided Key-words: Diabetic Foot, Surgical Management, Conservative Corresponding Author: Dr. Krunal Solanki Assistant Professor, Department of Surgery, Government Medical College, Bhavnagar INTRODUCTION: Diabetes has proved itself a silent killer disease. Today in the world maximum numbers of the patients are suffering from this disease, and moreover they are passing through the associations of the complications too. According to WHO diabetes is a chronic disease that occurs when the pancreas doesn’t produce enough insulin or alternatively, when body cannot effectively use the insulin it produces. It has a heterogeneous clinical syndrome in which the central feature is a chronic elevation of the blood glucose concentration, which is associated with long term tissue damage especially the blood vessels, nerves, heart, kidneys and eyes. Diabetic foot is defined as ‘infection, ulceration and or destruction of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limb’ . The term diabetic foot indicates that there are specific qualities about the feet of people with diabetes that sets this disease apart from other conditions that affect the lower extremity. Evidence prove that the pathophysiological process of diabetes have put the foot at increased risk for tissue damage. Tissue damage has occurred and the foot is at risk for end stage complication. 50% of all lower extremity amputations (LEA) are diabetes related.>70% of LEA’s are preceded by a foot ulcer.3-10% of those with diabetes have a foot ulcer.15% of all those with diabetes will, during their life time develop an ulcer. The international working group on the diabetic foot proposed the PEDIS classification: It grades the wound on the basis of 5 feautures. i.e. perfusion , Extent (area) ,Depth, Infection and