Abstract
The multidisciplinary team approach to diabetic foot disorders and critical limb ischemia (CLI) has been demonstrated as the optimal method to achieve favorable rates of limb salvage. A team approach has played an integral role in preventing major limb amputation in our wound care center, which consists of a vascular surgeon, cardiologist, plastic surgeon, and orthopedic surgeon. Revascularization and debridement are key procedures for wound bed preparation that should be performed in a timely and ordered manner. Moist wound treatment is then useful for early healing. We used additive therapies, such as maggot debridement therapy (MDT), negative pressure wound treatment (NPWT), and platelet rich plasma (PRP). We treated 213 limbs in 195 cases of chronic wounds over a period of 4 and a half years. The rate of limb salvage in 52 limbs with diabetic foot ulcers or gangrene was 88.5%. Fifty-three revascularizations (23 intravascular interventions, 27 bypass surgeries, and 3 hybrid therapies) were performed in 113 limbs with CLI. The rate of limb salvage with CLI was 68.1%.
