Aggressive limb salvage using tibio-pedal bypass grafting with free tissue transfer in a diabetic patient.
A 63-year-old man presented with intermittent claudication, diabetes, and an ischaemic heel ulcer. After control of infection, the os calcis was left exposed. An aggressive combined infra-inguinal revascularization and reconstruction procedure involving free-tissue transfer resulted in rapid wound healing with independent walking by day 26. Recent improvements in surgical techniques mean that this approach should be considered in selected patients.
Walmsley
D
D
Department of Diabetes, Aberdeen Royal Infirmary, Scotland.
Inglefield
C J
CJ
Naylor
A R
AR
Murchison
L E
LE
Kolhe
P S
PS
Cooper
G G
GG
D000792:Angiography; D001161:Arteriosclerosis / Q000473:pathology; D003925:Diabetic Angiopathies / Q000601:surgery*; D017719:Diabetic Foot / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication; D008297:Male; D008875:Middle Aged; D016909:Tibial Arteries / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014945:Wound Healing