Current Surgical Approach in the Pathology of the Arteriopathic Predominant Diabetic Foot.

Abstract

Introduction: The diabetic foot is a complex pathologic entity characterized by the totality of modifications appearing on the foot during the evolution of the diabetic disease. This survey aims to elaborate an algorithm of treatment for patients with arteriopathic predominant diabetic foot lesions, with the purpose of reducing the number of debilitating interventions and improving the quality of life. Material and Method: There were analysed a number of 188 patients admitted to the Surgery Clinic I of the Dr.I.Cantacuzino Clinical Hospital, in the year 2017, suffering from arteriopathic predominant diabetic foot lesions, based on several inclusion/exclusion criteria. Results: According to the type of foot lesion, most patients had the diagnosis of wet gangrene of the toe/toes (51.06%), followed by ischaemic gangrene of the toe/toes (40.4%); the surgical interventions performed on these types of lesions in 73.9% of the cases consisted of minor amputations (transmetatarsal amputation of the toe/toes/foot). Conclusions: The treatment algorithm developed as a result of this survey represents a feasible treatment solution for the pathology of the arteriopathic predominant diabetic foot and failure to comply with this treatment may lead to treatment errors in a sense in which disproportional surgery can be performed in correlation with an inexact diagnosis.