For people with diabetes, wounds may not heal normally due to nerve damage and poor blood circulation. As a result, diabetic foot ulcers can cause long-lasting effects like tissue damage, infection, or even amputation. Walking around on an injured foot can also lead to bone fracture and foot deformities such as Charcot foot and midfoot collapse.
Treatment of diabetic foot issues may include orthotics (special shoes or braces) or surgical options. Limb-saving surgery makes it possible to treat the most serious cases by reconstructing a functional limb. The goal of treatment is to prevent amputation and also preserve limb function so you can keep moving and doing the things you enjoy.
Similarly, people with peripheral artery disease (PAD) have reduced blood flow to their limbs, especially the legs. This is caused by atherosclerosis, a narrowing of the arteries caused by fatty deposits called plaque. Over time, this can progress to critical limb ischemia (CLI), which can cause severe leg or foot pain, slow-healing sores or even gangrene. Limb salvage is a grouping of treatments to avoid amputation.
The experts in our Vascular and Endovascular Program offer the most current minimally invasive treatments for limb salvage. Our team’s expertise means we can save patients’ feet and legs when traditional therapies fail.
What types of limb salvage treatments are available?
We offer a number of treatment options to improve blood flow and reduce the risk of amputation, including:
- Angioplasty, a procedure to push plaque blockages against the walls of an artery
- Atherectomy, a procedure to cut plaque out of a narrowed artery
- Stenting, which involves implanting a small, expandable tube called a stent in the narrowed artery to help keep it open and allow blood to flow
- Bypass, using a vein or synthetic tube to bypass the area of blockage and carry blood to the area of need
Planning and recovery
Planning
At MedStar Health, our diabetic limb specialists offer the most advanced treatment options for people who suffer from these diabetes-related foot problems. Limb-saving surgery is a complex procedure that may involve bone reconstruction, tendon transfer, and soft tissue reconstruction. We have expertise in Charcot foot reconstruction, as well as external fixation, a technique that uses advanced computer technology to assist surgeons during the reconstruction procedure.We work together with the specialists you need, including wound care specialists, vascular and plastic surgeons, foot and ankle surgeons, and your endocrinologist to create a treatment plan that will manage your condition most effectively. Our team approach gives you access to a full spectrum of diabetic wound services including:
- Debridement is the medical removal of damaged or infected tissue to improve the healing ability of remaining tissue.
- Diabetic shoe service evaluates you for specialized, prescription footwear designed to reduce the risk of wounds or injuries as a result of diabetic neuropathy (nerve damage).
- Gait evaluation analyzes how you stand or walk to detect areas of pressure and potential ulceration.
- Hyperbaric oxygen therapy (HBOT) delivers oxygen to the wound by breathing 100 percent oxygen in a special chamber, increasing blood flow to affected areas to heal your wounds faster.
- Prosthetic devices improve mobility with an artificial limb in cases when an arm or other extremity is amputated or lost.
- Total contact casting involves fitting a non-removable cast to protect the affected limb.
Recovery after limb-saving surgery
Recovery from diabetic limb salvage surgery may take some time. You will need to stay off your feet immediately after surgery. Then, you will likely need to wear special braces and shoes to cushion your feet as they continue to heal. We may also recommend physical therapy to help you regain strength in your feet. Your foot and ankle surgeon will discuss the specific details of your recovery with you before your procedure.
Conditions
Leg and foot ulcers
Open sores that are long-lasting, keep returning, and are resistant to treatment.
Peripheral artery disease (PAD)
Peripheral artery disease (PAD) occurs when blood flow to the arms and legs is reduced due to narrowed or blocked arteries.
Tests
Angiogram (Angiography)
An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.
Arterial duplex ultrasound for arms and legs
Arterial duplex ultrasound uses Doppler and traditional ultrasound to assess blood flow in the arteries of your arms and legs.
Pulse volume recording
Pulse volume recording tests are used to evaluate blood flow through the arteries in your arms or legs.
Our providers
Location: Change location Enter your location
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Margaret Walkup Arnold, MD
Vascular Surgery
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Joshua A. Dearing, MD
Vascular Surgery
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Manisha Salvador Durkee, CRNP
Vascular Surgery
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Yelena Game, PA-C
Vascular Surgery
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Geetha Jeyabalan, MD
Vascular Surgery
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Ryan S. Murray, MD
Sports Medicine, Orthopedic Sports Medicine, Pediatric Sports Medicine & Pediatric Orthopedic Surgery
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Dana Lurae Parker, CRNP
Vascular Surgery
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Kyle B. Reynolds, MD
Vascular Surgery
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Danielle Salazar, MD,MA
Vascular Surgery
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Stephen Fulvio Stanziale, MD
Vascular Surgery
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Raghuveer Vallabhaneni, MD
Vascular Surgery
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Edward Yiming Woo, MD
Vascular Surgery
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Sarkis Garabet Aghazarian, MD
Vascular Surgery
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Selin Sakarcan, DPM
Podiatry
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Richard A. Silva, MD
Vascular Surgery
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Lauryn R Smith-Winton, DPM
Podiatry
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Frequently asked questions
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Do I need a referral for Wound Care Services?
You may be referred to the Center for Wound Healing and Hyperbaric Medicine by your primary care physician, endocrinologist, or other specialists. Your primary physician will continue to manage your main health condition, such as diabetes or heart disease, and a wound specialist will manage your wound care.
If you’re exploring options for insurance coverage, you may need to request a referral from your primary care doctor, depending on your health insurance plan. Check with your carrier to see if medical coverage is an option for you and, if so, whether a referral is required.
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What foot problems can be caused by diabetes?
Diabetic neuropathy (loss of normal nerve sensation) and peripheral vascular disease (poor circulation) can cause serious problems including:
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Diabetic foot ulcers (wounds that do not heal)
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Infections of the skin or bone
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Gangrene (dead tissue caused by loss of circulation)
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Charcot foot (fractures and severe deformities)
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What can I do to take care of my feet?
Try these tips for good foot hygiene from the National Institute of Diabetes and Digestive and Kidney Diseases:
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Check your feet every day
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Wash your feet every day
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Keep the skin soft and smooth
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Smooth corns and calluses gently
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Trim your toenails regularly if you can see, reach, and feel your feet. If you cannot, ask a foot doctor (podiatrist) to trim them for you.
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Wear shoes and socks at all times
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Protect your feet from hot and cold
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Keep the blood flowing to your feet
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What can I do help the healing process?
Getting medical treatment for your wound is key to recovery, as well as treating any underlying health issues affecting the healing process. If you have diabetes, it’s important to keep your blood sugar under control. You should also follow a healthy diet to ensure your body is getting the nutrition it needs to promote wound healing. Ask your doctor about starting a diabetes education program.
Our locations
Distance from Change locationEnter your location
MedStar Health: Plastic Surgery at MedStar Georgetown University Hospital
3800 Reservoir Road NW, BLES Building 1st. Floor Washington, D.C., 20007
866-990-5515
MedStar Health: Podiatric Surgery at MedStar Washington Hospital Center
106 Irving St. NW POB North Ste. 3400 Washington, D.C., 20010
MedStar Union Memorial Hospital
201 E. University Pkwy. Baltimore, MD 21218
MedStar Health: Medical Center at Mitchellville
12158 Central Ave. Mitchellville, MD 20721
Additional information
Diabetic limb salvage conference
Highly regarded as one of the world’s finest limb salvage events, the Diabetic Limb Salvage conference brings together the most eminent lower limb specialists for an unforgettable meeting. The Diabetic Limb Salvage conference equips each member of the healthcare team with the education and resources needed to heal wounds and prevent amputations.
Vascular and endovascular program
Partner with a recognized leader in offering care ranging from straightforward vascular disease to the most complex vascular disorders.