Diabetic Foot Reconstruction
Saving Limbs, Restoring Mobility
Diabetes is one of the most common chronic diseases in India, and one of its most serious complications is the diabetic foot. Foot ulcers, infections, and gangrene are unfortunately very common in people with long-standing diabetes, especially when blood sugar control is poor.
At our centre, we focus on early detection, prevention, and reconstruction of diabetic foot problems to save limbs and improve quality of life. Many patients who might otherwise face amputation can be treated successfully with timely and coordinated care.
Understanding the Diabetic Foot Problem
High blood sugar levels over time damage the body s small blood vessels and nerves especially in the legs and feet. This leads to:
- Loss of sensation (neuropathy): Patients don t feel pain or pressure, so small injuries go unnoticed.
- Poor blood circulation (angiopathy): Wounds heal slowly and are prone to infection.
- Foot deformities: The shape of the foot changes, leading to abnormal pressure points
and ulcers. - Reduced immunity: Even minor infections can quickly spread.
A simple blister or callus can turn into a non-healing ulcer. Without proper care, infection spreads to the bone, leading to gangrene and, in severe cases, amputation.
Living With Diabetes — Prevention Is the Best Cure
- Keep blood sugar under strict control
- Inspect your feet daily for cuts, blisters, or colour changes
- Never walk barefoot, even at home
- Use soft, well-fitted footwear
- Report any non-healing wound or swelling immediately
- Schedule regular foot checkups with your doctor
Our Approach to Diabetic Foot Care
At our hospital, we follow a stepwise, team-based approach to treat diabetic foot disease.
1. Early diagnosis and infection control:
We begin with prompt cleaning and debridement (removal of dead and infected tissue) to control infection and promote healing. Proper wound bed preparation is the foundation of successful reconstruction.
2. Pressure offloading:
We use special footwear, total contact casts, or customized orthoses to redistribute pressure and prevent recurrence of ulcers. This is a cornerstone of diabetic foot management and helps existing wounds heal faster.
3. Surgical offloading:
In selected patients, we perform surgical procedures to correct deformities or redistribute pressure in
the foot. These include:
- Tendo-Achilles lengthening to reduce forefoot pressure
- Plantar fascia release for chronic plantar ulcers
- Metatarsal head resection or osteotomy to offload prominent bones causing recurrent ulcers
- Correction of claw toes to restore a stable, plantigrade foot
These procedures are aimed at preventing recurrent ulcers and improving long-term mobility.
4. Revascularisation (restoring blood flow):
In collaboration with vascular surgeons, we assess circulation using Doppler or angiography and restore blood flow when needed through angioplasty or bypass surgery.
5. Reconstruction:
When there is significant tissue loss, we provide definitive soft-tissue cover using local flaps, regional flaps, or free microsurgical flaps. These ensure durable wound closure and prevent reinfection.
6. Rehabilitation and prevention:
After healing, patients undergo physiotherapy, gait training, and custom footwear fitting. We also educate every patient about foot care and ulcer prevention to avoid recurrence.
Reconstructive Options in Diabetic Foot
Depending on the size and depth of the wound, various techniques are used:
- Skin grafts for superficial wounds after good granulation
- Local flaps for small to moderate defects (rotational or advancement flaps)
- Free tissue transfer (microsurgery) for large or complex wounds with exposed bone or tendons
- Tendon transfers or partial amputations in advanced cases to preserve maximum function
Our goal is always limb salvage — saving the leg or foot whenever possible. Every centimetre of preserved limb translates to better balance, walking ability, and independence
The Importance of Multidisciplinary Care
Successful diabetic foot management depends on teamwork. Our diabetic foot team includes:
- Plastic surgeons – for wound closure and reconstruction
- Diabetologists / endocrinologists – for blood sugar control
- Vascular surgeons – to restore circulation
- Podiatrists – for pressure offloading and footwear advice
- Physiotherapists and orthotists – for rehabilitation and gait training
This collaborative approach ensures that both the underlying disease and its complications are addressed, reducing the risk of recurrence.
Why Consult a Plastic Surgeon for Diabetic Foot?
Plastic surgeons play a central role in limb salvage. Our expertise lies in:
- Providing healthy, durable soft-tissue cover over bone and tendons
- Performing microsurgical flaps for complex wounds
- Coordinating with vascular and diabetic teams for holistic management
- Restoring the patient’s ability to walk and lead a normal life
Timely intervention by a plastic surgeon can mean the difference between losing a limb and walking again
FAQs on Diabetic Foot and Reconstruction
1. Why do foot ulcers form in diabetes?
Due to nerve damage and poor blood flow, small injuries go unnoticed and fail to heal, leading to ulcers.
2. Can a diabetic foot be cured without surgery?
Early ulcers can heal with good sugar control, dressings, and offloading. However, once there is deep infection or exposed bone, surgical debridement and sometimes flap cover are necessary.
3. How does a plastic surgeon help in diabetic foot care?
Plastic surgeons reconstruct the wound using grafts or flaps, ensuring that the area heals well and can bear weight again — preventing amputation.
4. Will I be able to walk normally after reconstruction?
Yes, with proper wound healing, physiotherapy, and customized footwear, most patients regain full mobility.
5. What is a “free flap” surgery?
It’s a microsurgical technique where healthy tissue from another body area is transferred to cover the wound, restoring blood supply and promoting healing.
6. How can I prevent diabetic foot ulcers?
Maintain good blood sugar control, inspect your feet daily, wear proper footwear, and consult your doctor promptly if you notice any wound or swelling.
7. Is amputation always necessary in diabetic foot?
No. With early intervention and modern reconstructive techniques, many patients can avoid amputation and save their limb.