Surgical treatment of the infected diabetic foot

Foot infections are common in the diabetic patient. Early recognition, proper assessment, and prompt intervention are vital. A combination of surgery and antibiotics is mandatory in virtually all foot infections. The aim of surgery is 2-fold: first, to control the infection, and second, to attempt to salvage the leg. The eventual goal is always to preserve a functional limb. Foot deformities resulting from surgery may cause reulceration and a high morbidity. The surgical treatment of the infection largely consists of draining of pus and removal of all necrotic and infected tissue. Frequently, revascularization of the foot is needed to save the limb; thus, there must be a close cooperation with the vascular surgical service. The surgeon must have a thorough knowledge of foot anatomy and must be familiar with the defects in wound healing that are caused by diabetes. The outcome of surgery mainly depends on the skill, care, and experience of the surgeon. The best results are achieved within a multidisciplinary setting.