Sunday, April 25, 2010

Diabetic Foot Surgery

When discussing surgery with patients, I often hear "I'm diabetic, is it safe for me to have surgery?". There are several factors to consider when you are diabetic and contemplating foot surgery. There are times when surgery is not an option, when it is necessary due to infection to prevent limb loss. But there are times when foot surgery is needed to prevent pressure areas that can become ulcers. And as I have discussed previously, ulcers when not treated lead to amputation.

The first thing to know when discussing foot surgery is do you have enough blood flow to the foot to heal the surgery. If your pulses cannot be easily felt by hand then a noninvasive test can be performed to give us a picture of how much blood is reaching the foot. If there is a significant decrease, then a referral to a vascular surgery is necessary before surgery is performed.

Second, understand that you are at higher risk for infection post op due to your diabetes. If your diabetes is not controlled this increases your risk even further. You will be given an antibiotic immediately preop and depending on the procedure may even take an antibiotic for a few days post op to reduce your risk of infection.

Third, are you healthy enough to undergo surgery and the post op requirements? A complete physical needs to be performed to make sure your heart, lungs and kidneys are working properly and there are no surprises.

So, it is ok for foot surgery in diabetic patients. A complete work up should be done before your surgery and you should ask as many questions as you can so that you understand the surgery and why it is needed. At Foot and Ankle Associates of North Texas, we strive to make sure all our patients are fully informed of their procedure and the associated benefits, risks and complications.