Multidisciplinary approach to scheduling surgery for diabetic foot: a case report

Guangyu Wang,Yu Wang,Leiyong Wang,Xuying Xu

doi:10.1186/s12891-019-2522-3

Abstract

BackgroundThe treatment of diabetic foot ulcers in this case is complex and multidisciplinary, and an interdisciplinary team is extremely beneficial.Case presentationWe performed the intervention on an old type 2 diabetes patient with poor health, whose left toes were severely necrotic. Surgery, including debridement and patella truncation, had positive effects on lower extremity circulation, infection control, cavity treatment, bone destruction, surgical debridement, recovery of foot function, and nursing. After 5 months, the patient’s foot ulcer had healed, and walking function was preserved.ConclusionsScheduling interventional surgery and debridement are the key point in a complicated diabetic foot ulcers case, and multidisciplinary collaboration in treatment of diabetic foot is significantly important.

Highlights

In China, in 2010, the prevalence of diabetes was 11.6% [1], while the proportion of diabetic patients > 50 years old with lower extremity arterial disease was 19.5% [2]; the proportion of diabetic patients > 60 years old with lower extremity arterial disease was 35.4% [3]
Diabetic foot ulcers have gradually become a challenge in clinical therapy and a leading cause of hospitalization among patients with diabetes [5]
The medical community has reached a consensus in favor of multidisciplinary collaboration in treatment of diabetic foot [6,7,8,9]

Summary

Introduction

In China, in 2010, the prevalence of diabetes was 11.6% [1], while the proportion of diabetic patients > 50 years old with lower extremity arterial disease was 19.5% [2]; the proportion of diabetic patients > 60 years old with lower extremity arterial disease was 35.4% [3]. The complexity of treatment for diabetic foot determines the importance of optimizing the timing of multi-disciplinary and sequential treatments This case presentation describes a complicated process of treatment for an elderly patient with diabetic foot ulcers, who had signs of poor baseline physiology. The left lower limb has been numb for 6 years, with intermittent claudication and rest pain for 1 year. Irritation and pain developed on the lateral skin of the toes of the left foot, with no obvious inducement. The five toes of the left foot were black, necrotic, and associated with aggravated rest pain. From July 25th to September 30th, the left foot plaster was fixed at a functional position and applied intermittently (Fig. 5a, b, c, d, e and f ). The first signs of wound healing were observed on November 19 (Fig. 5g, h and i)

Discussion

Conclusions