Clinial Evaluation of the Diabetic Foot Associated with Peripheral Vascular Disease or Renal Failure

ABSTRACT

In the treatment of this complicated diabetic foot patient, we need an effective treatment principle because the complicated diabetic foot patient needs a longer hospitalization period and suffers from more frequent recurrences. We reviewed 43 diabetic foot patients who were treated in our department during the past 4 years. The 43 patients were divided into 4 groups according to their combined complications. Group A was the simple diabetic foot group(no complication group, n = 17). Group B was the diabetic foot group combined with the extensive cellulitis(n = 9). Group C was the diabetic foot group combined with the peripheral vascular disease(n = 8). Group D was the diabetic foot group combined with the renal failure(n = 9). As a results, wide range of reconstructive methods can be selected in the simple diabetic foot group. In group B, early and wide debridement was important to control the infection and later flap reconstruction was appropriate. In group C, the bypass operation should be desperate before improving the circulation of lower extremities, and therefore we successfully reconstructed the foot with various metohds including plantar V-Y advancement flap, considered as the most useful in our series. In group D, recurrence was more frequent and lower extremity amputations above the ankle level couldn't be avoided in spite of many operations and longer hospitalization. Therefore consideration of early amputaiotn is recommended for the effective treatment of this group.