Abstract
Aim: Analyse the impact of definitive corrective surgery on the course of chronic non-healing diabetic foot ulcers.
Method: The specialist diabetic foot clinic at the Kings College Hospital had six thousand attendees in the period Sept 2007 to Sept 2008. We retrospectively reviewed a group of patients with Neuropathic chronic non-healing diabetic foot ulcers who were referred for surgical correction. They underwent a minimum of twelve months of conservative treatment including pressure-relieving methods such as total contact casts. They were all classified as B3 according to the Texas diabetic wound classification at the time of referral; infection was controlled with antibiotics before correction. Seven ulcers were located over the forefoot, and six over the hind foot. Thirteen patients had definitive corrective surgery. Five using Taylor spatial frames and eight had corrective osteotomies and fusions. The period of ulcer prior to surgery together with the time to healing of the ulcer postoperatively was calculated in each case.
Results: There were ten Males and three Females, with a mean age of 57.4 years ranging from 37 to 75 years. The Mean period of ulceration prior to surgical intervention was 4.2 years. Nine ulcers healed in a mean duration of three months with a maximum of six months. One ulcer is improving and three have failed to heal so far.
Conclusion: Definitive corrective surgery on chronic non-healing diabetic foot ulcers is an important tool to reduce the healing time.
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