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Soft Tissue Reconstructive Options for the Ulcerated or Gangrenous Diabetic Foot

  • Chapter
The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Diabetic foot and ankle wounds usually occur because of acute or repetitive trauma in an insensate and biomechanically unstable foot. The body is unable to heal the wound owing to persistent trauma, biomechanical abnormality, infection, inadequate blood flow, ineffective immune system, or poor nutrition and the acute wound converts into a chronic wound. The goal is to transform the chronic wound into an acute healing wound with healthy granulation tissue, neoepithelialization, and wrinkled skin edges. The steps to achieve a healthy healing wound include establishing a correct diagnosis, ensuring a good local blood supply, debriding the wound to a clean base, correcting the biomechanical abnormality, and nurturing the wound until it shows signs of healing. The subsequent reconstruction can then usually be accomplished by simple techniques 90% of the time and complex flap reconstruction in 10% of cases. It may involve partial foot amputation to develop a sufficient tissue envelope to close the wound or to stabilize the foot biomechanically.

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Authors and Affiliations

  1. Wound Healing Center, Georgetown University Hospital, Washington DC

    Christopher E. Attinger MD (Director)

  2. Georgetown University School of Medicine, Washington, DC

    Christopher E. Attinger MD (Director)

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  1. Christopher E. Attinger MD
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Editors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

    Aristidis Veves MD, DSc , John M. Giurini DPM  & Frank W. Logerfo MD ,  & 

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Attinger, C.E. (2006). Soft Tissue Reconstructive Options for the Ulcerated or Gangrenous Diabetic Foot. In: Veves, A., Giurini, J.M., Logerfo, F.W. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-59745-075-1_19

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  • DOI: https://doi.org/10.1007/978-1-59745-075-1_19

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