diabetic foot ulcers

Diabetics have two major conditions affecting the feet, neuropathy, and vasculopathy. Neuropathy is the dysfunction of one or more peripheral nerves, causing numbness and weakness. Typically, diabetics don’t feel when they have injured their feet, due to numbness, resulting in an injury that can have blood loss trauma. Vasculopathy is described as any disease affecting the blood vessels.

Flap in medical terms is a mass of tissue for grafting, usually including skin, only partially removed from one part of the body so that it retains its blood supply (unlike nonvascularized skin grafts) during transfer to another site, in this case, the foot. There are a variety of flaps ranging from rotational flaps and local muscle flaps to pedicle flaps and perforator flaps. Determining which type of flap is needed for coverage, an evaluation will be performed.

A rotation flap is a semicircular skin and subcutaneous tissue that rotates about a pivot point into a defect which provides the ability to mobilize large areas of tissue with a wide vascular base for reconstruction.

Local Muscle flap is to provide a well-vascularized soft tissue that is relatively resistant to infection, helps wounds heal, and offers a vascularized surface, it’s commonly used to eradicate the infection and to revascularize bone.

Pedicle flaps are left attached to the original site by a narrow base of tissue to provide a blood supply during grafting.

Perforator flaps include the deep inferior epigastric artery, the anterolateral thigh, the thoracodorsal artery, and the superior and inferior gluteal artery perforator flaps.

Free flap reconstruction is known as free tissue transfer, in which tissue and its blood supply are surgically removed from one part of the body and transferred a significant distance to another part of the body for reconstruction.

These plastic surgical wound closure technics along while providing function and durable soft tissue coverage to promote anatomic alignment and stability, are all exceptional care that is specific to each patient. Before the procedure, an evaluation is made for the wound closure of the area based on the patient's needs, health status, and psychological issues, and goals of care.

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