Diabetic foot salvage: breaking paradigms through a case report

Abstract

Diabetic foot (DF) is one of the most frequent and disabling complications of diabetes mellitus 2 (DM2). This study presents the case of a 66-year-old female patient with DM2 and DF complicated by extensive infected necrosis involving more than 50% of the foot. She was not a candidate for revascularization and, due to the poorly controlled septic focus and the extent of necrosis, infracondylar amputation was indicated. However, as the patient refused to undergo amputation, the case was re evaluated at another health institution and a multidisciplinary therapeutic plan for DF salvage was proposed. The protocol included antibiotic therapy, surgical debridement, periodic outpatient dressing, and negative pressure wound therapy (NPWT). After ten months of treatment, the limb showed almost complete healing, and amputation was not necessary. Management of complicated DF is currently one of the greatest clinical-surgical challenges, requiring a highly trained multidisciplinary team to propose an optimal limb salvage program. Level of Evidence V; Case Report; Expert Opinion.

Keywords

• Diabetic foot
• Necrosis
• Amputation
• Wound healing
• Negative pressure wound therapy