Prophylactic plastic surgery to prevent the recurrent foot wound

Higashita Ryuji, Kikuchi Kyota, Fujimoto Masashi, Rinoie Chugo

doi:10.7792/jlspm.5.95

Prophylactic surgery performed on diabetic foot and on neuropathic foot deformity generally have an aim to reduce the risk of foot ulceration and amputation by correcting structural deformities that often lead to cutaneous compromise. Although these surgeries may be significant in preventing further debilitating conditions from developing, prophylactic surgeries are often hesitated from being performed after the chronic wounds have healed because of the risk of infection or inadequate blood supply. We, here, introduce two cases where prophylactic surgery has prevented further recurrence of wound. A 41-year-old male with diabetes mellitus experienced an amputation of 2nd digit followed by the healing of the amputation site, however callus has been repetitively forming on the plantar area ever since. Achilles tendon lengthening, resection of calcaneal spur, and correction of the hammer toes were performed, and no further callus has been forming after the procedures. A 33-year-old female, who underwent resection of left popliteal angioma during her childhood, experienced disturbance in growth of left lower limb which lead to complicated deformity such as equinovarus, adductus and hammer toe. The severe deformity was causing repetitive ulceration, and corrective surgery for equinovarus, adductus and hammer toe were performed to prevent further recurrence. Both patients have not had recurrence since these prophylactic surgeries have been performed. Limb salvage can be greatly enhanced with an aggressive approach with prophylactic procedures on the neuropathic foot including diabetic foot.

Prophylactic plastic surgery to prevent the recurrent foot wound

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