Diabetic Foot : Even the smallest part of the foot is important
As can be seen from this picture, in the normal foot, the arches are present and in resting position all the bones of the foot are involved for transmitting pressure.
Removing even a part of the toe, changes the pressure distribution and the pressure is then on other parts of the foot which are not designed for such pressure.
So removal of even a small part of the foot leaves the patient with a lifelong risk of re ulceration.
This is also the reason we do not advocate skin grafting in diabetic foot wounds and encourage formation of skin on the wound as any skin taken from other parts of the body is unable to bear the pressures in the foot.
Apart from this, a Split Thickness Graft has a tendency to contract over time leading to foot deformities and recurrent ulceration.
Similarly flaps are also not advisable as they dis-balance the foot and make it prone to further injury.
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