There are numerous factors resulting in tissue damage and foot ulcers in diabetic
patients. Critical ischaemia should be routinely excluded and an examination of the
limb perfusion must be done in all cases with clinical suspicion of reduced perfusion.
Pedal bypass grafting procedures in combination with flap plasty techniques achieve
good results in patients with non-healing diabetic ulcers. Timing of the procedure
is essential to avoid progression of gangrene. Good results of pedal bypass grafts
support an indication at an early stage. Vacuum assisted wound therapy and local wound
surgery can be done first to prepare patients with septic foot lesions for two-staged
procedures
Diabetic foot - pedal bypass - vacuum therapy - flap plasty - microvascular surgery
- distal extremity reconstruction
