Health on the Edge: Surgical Treatments for DFU
Surgical Intervention
(Surgical Treatment)
Surgery is an invasive treatment and can be considered the most direct way to deal with a lesion, ranging from minor wound debridement to major limb amputation. Although surgery is usually considered when symptoms are severe or conservative treatment is ineffective, appropriate surgery when necessary can delay the progression of the disease and prevent serious complications1. Common surgeries for Diabetic Foot Ulcers (DFUs) include the following：
- Wound Debridement (surgical/sharp debridement)：
The main purpose is to remove necrotic or non-viable tissue, including healing tissue (i.e., calluses formed by scabs), to promote the formation of granulation tissue and re-epithelialization. This not only effectively reduces inappropriate pressure on the foot but also prevents tissue infection while increasing the contact area and efficacy of topical medications2.
Are there many methods of wound debridement, and is surgery necessary?
"Non-Surgical Options for DFUs: Medication and Adjunctive Therapies"
- Revascularization：
Is a type of surgeries, which include many kinds of surgical3, but all aim at patients with DFU who also have chronic symptoms of lower limb ischemia, intending to increase blood flow to the patient's foot, effectively promote wound healing, and reduce the incidence of major amputations4.
- Amputation：
Is a surgery that remove a body part or limb segment, which can be divided into “minor amputations”, or “major amputations” that require partial limb removal5; it can also be classified according to the location of amputation, such as toe amputation, ankle disarticulation, below-knee amputation, and so on.
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Reference：
- Senneville É et al. Diabetes Metab Res Rev. 2023;e3687.
- Everett E et al. Ann N Y Acad Sci. 2018;1411(1):153-165.
- Beckman JA et al. Circ Res. 2021;128(12):1885-1912.
- Armstrong DG et al. JAMA. 2023;330(1):62-75.
- van Netten JJ et al. Diabetes Metab Res Rev. 2023;e3654.