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:: SURGICAL DECOMPRESSION OF THE DIABETIC INFECTED FOOT

Product of personal experience* in dissecting amputated limbs and the understanding of the pathodynamics of the spread of infection in the diabetic foot viz. along the long flexor, intterosseous and lumbical tendons. Pus and gas (in anaerobic infections) accumulates in the mid compartment of the sole between the plantar fascia and the fourth layer causing compression of the plantar vascular arch thus resulting in distal digital ischaemia and gangrene; proximal spread of the infection medially and upwards above the ankle (through the tarsal tunnel) to soleal region causes thrombosis of the subsoleal venous plexus, arterial compression and systemic toxaemia, very often resulting in major amputation of the limb.

Based on this understanding the surgical decompression technique has been developed, which when carried out correctly, results in a dramatic alround improvement and prevents amputation in over 90% of the cases. The three levels of this decompression surgical procedure viz. plantar level, ankle level, and the subsoleal level have been worked out after much experience.

* The surgical Decompression technique is the original work evolved by Dr. N. S. Murali our collaborating Consultant Surgeon.


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