title: Innovations in diabetic foot reconstruction using supermicrosurgery.
abstract: The treatment of diabetic foot ulceration is complex with multiple factors involved, and it may often lead to limb amputation. Hence, a multidisciplinary approach is warranted to cover the spectrum of treatment for diabetic foot, but in complex wounds, surgical treatment is inevitable. Surgery may involve the decision to preserve the limb by reconstruction or to amputate it. Reconstruction involves preserving the limb with secure coverage. Local flaps usually are able to provide sufficient coverage for small or moderate sized wound, but for larger wounds, soft tissue coverage involves flaps that are distantly located from the wound. Reconstruction of distant flap usually involves microsurgery, and now, further innovative methods such as supermicrosurgery have further given complex wounds a better chance to be reconstructed and limbs salvaged. This article reviews the microsurgery involved in reconstruction and introduces the new method of supermicrosurgery.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Suh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Tae Suk
authors.initials: TS
authors.lastname: Oh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Joon Pio
authors.initials: JP
authors.lastname: Hong
mesh_terms: D003131:Combined Modality Therapy; D003226:Congresses as Topic; D003646:Debridement / Q000009:adverse effects / Q000639:trends; D003663:Decision Trees; D017719:Diabetic Foot / Q000534:rehabilitation / Q000601:surgery* / Q000628:therapy; D019317:Evidence-Based Medicine; D005528:Foot / Q000601:surgery; D006801:Humans; D023821:Limb Salvage / Q000009:adverse effects* / Q000639:trends; D008866:Microsurgery / Q000009:adverse effects* / Q000639:trends; D011183:Postoperative Complications / Q000517:prevention & control; D057285:Precision Medicine; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000639:trends; D016038:Skin Transplantation / Q000009:adverse effects / Q000639:trends; D035703:Therapies, Investigational / Q000009:adverse effects* / Q000639:trends; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000639:trends
keywords: diabetic foot; microsurgery; reconstruction; supermicrosurgery