Conservative Surgical Options for the Treatment of Forefoot Diabetic Ulcers and Osteomyelitis: An Evidence-Based Review and a Decision-Making Tool.

摘要: Diabetic foot ulcers cause higher rates of amputation and mortality; amputations yield even mortality than diabetic ulcers. Conservative excisional surgical procedures could be a suitable alternative to amputations, with comparable results respect wound-healing infection control. Also, toe-sparing conservative offer good excellent outcomes when compared the nonoperative standard care. Fourteen types were identified including bone excision ulcerectomy, interphalangeal or metatarsophalangeal joint resection arthroplasty, internal pedal phalangeal metatarsal bone, distal Syme amputation, osteotomy, head resection, Achilles lengthening, gastrocnemius recession, selective plantar fascia release, percutaneous toe flexor tenotomy, skin grafting. Depending on location ulcer osteomyelitis, decision-making tree tool has been developed assist surgeons for indication different operations. A striking underuse available operations was noted. When indicated, surgery rated excellent; these alternatives amputation.