diabetic foot ulcer, soft-tissue coverage, surgical reconstruction of the foot



  1. Akhtar, Sohaib MD, MBBS, MS, MCh
  2. Ahmad, Imran MBBS, MS, MCh
  3. Khan, A.H. MBBS, MS, MCh
  4. Khurram, M. Fahud MBBS, MS, MCh, DNB


OBJECTIVE: The objective of this study was to establish an algorithm for surgical reconstruction of diabetic foot ulcers (DFUs).


STUDY DESIGN: Retrospective study


MATERIALS AND METHODS: In this series, 75 patients with diabetic foot ulceration were treated at the Jawaharlal Nehru Medical College from October 2008 to August 2013, and were retrospectively reviewed. All patients in the study underwent surgical reconstruction of the foot in the form of a skin graft, local flaps, or free flaps, depending upon the characteristic of the defect, general condition of the patient, and vascular status of the limb. The medical notes of the patients were retrospectively analyzed according to age, gender, ankle-brachial pressure index, and comorbidities.


RESULTS: Twenty-eight patients (37%) underwent skin grafting, 39 (52%) underwent local pedicled flaps, and 8 (11%) underwent free flap transfers. Sixty-eight patients (91%) achieved complete healing, and amputation of the lower extremity could be avoided. With the exception of 1 patient who experienced ulcer recurrence within the following year and 6 patients in whom amputation of the lower extremity was performed, all patients healed completely. The mean hospital stay was 4.0 +/- 1 week.


CONCLUSIONS: From the results of this study, the authors conclude that radical debridement and soft-tissue cover in the form of a skin graft/flap is an effective method of managing DFUs.