Many patients present with ulcers or skin changes that threaten their limbs to amputation. Delay in diagnosis and treatment or inadequate treatment can accelerate the limb loss. Diabetes mellitus, peripheral vascular disease and infection are major factors contributing to amputation. In patients with diabetes, the small vessels are affected in addition to poor resistance to infection that contribute to limb loss. Blood sugar control is important to help heal ulcers and infection in diabetes. In addition, an aggressive approach to improving blood flow is very essential. That might take minimally invasive (end-vascular) procedures from the groin or from the foot to open occluded arteries or surgery to bypass the area of occlusion. An aggressive approach means to open as many vessels as possible to help the healing process and improve blood flow. Control of infection via proper antibiotics is another factor that help healing. In many cases patients need to have special shoes to help offload the foot to allow healing process. In some cases high oxygen concentration to improve the oxygen delivery to the ulcer area can be achieved via delivering oxygen under high pressure ( hyperbaric oxygen). This complex approach requires the cooperation of many specialists to help heal and save limbs. Our team of specialist in vascular disease, complex vascular procedures, infectious disease, and orthotists contribute to the high salvage rates in patients with diabetic ulcers and other ulcers
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