Letter to the Editor

Limb Salvage Is a Viable Option in Managing Diabetic Foot Ulcers

Authors: Rajesh Nair, BSc, MD

Abstract

To the Editor: Limb salvage has become an important modality in treating diabetic foot ulcers as a result of advancements in surgical techniques and wound healing. Why the renewed interest in salvage procedures? Elderly patients with multiple comorbidities who have diabetes mellitus have differing expectations than younger, more active patients. It would make sense to treat wounds with salvage procedures so that the older adult patient can resume his or her lifestyle and maintain independent ambulation without the use of a below-the-knee prosthesis. Studies have found that amputees were 2.7 times less likely to use their prosthesis if they are older than 60 years of age and are twice as less likely if they have coronary artery disease.1 Five-year mortality rates after major amputations have ranged from 39% to as high as 80%,2 therefore making limb salvage important.

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References

1. Attinger CE, Brown BJ. Amputation and ambulation in diabetic patients: function is the goal. Diabetes Metab Res Rev 2012;28:93-96.
 
2. Hong JP, Oh TS. An algorithm for limb salvage for diabetic foot ulcers. Clin Plast Surg 2012;39:341-352.
 
3. Fitzgerald O’Connor EJ, Vesely M, Holt PJ, et al. A systematic review of free tissue transfer in the management of non-traumatic lower extremity wounds in patients with diabetes. Eur J Vasc Endovasc Surg 2011;41:391-399.
 
4. Laborde JM. Tendon lengthening for neuropathic foot problems. Orthopedics 2010;33:319-326.