title: External fixation for surgical off-loading of diabetic soft tissue reconstruction.
abstract: Early and aggressive treatment of diabetic foot wounds is imperative for the reduction of amputation risk. Whereas sound local wound care is important for successful management; chronic wounds often reach a stagnant point in healing because of diabetic vasculopathy, immunopathy, or neuropathy. The type, size, shape, and location of wound may not always allow primary closure or grafting. In patients with adequate perfusion and in the absence of infection, local advancement flaps are suitable for durable closure. A review and case report demonstrating the use of these flaps with external fixation as an adjunctive therapy for surgical off-loading is presented.
authors.affiliation: Division of Podiatric Medicine and Surgery, Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Ramanujam
authors.forename: Zacharia
authors.initials: Z
authors.lastname: Facaros
authors.forename: Thomas
authors.initials: T
authors.lastname: Zgonis
mesh_terms: D001177:Arthropathy, Neurogenic / Q000175:diagnosis / Q000601:surgery; D017719:Diabetic Foot / Q000175:diagnosis / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D013314:Stress, Mechanical; D013524:Surgical Flaps; D016896:Treatment Outcome; D016474:Weight-Bearing; D014945:Wound Healing / Q000502:physiology*