Diabetic patients and those with peripheral vascular disease are more prone to developing wounds of the extremities, especially the lower extremity. This is due to reduced blood supply, along with loss of sensation to the toes, feet, and ankles. Left untreated, these wounds often get infected or turn gangrenous. Adequate early management along with diabetic control is key to prevention of complications. Established wounds can also be treated with a combination of debridement, special dressings, and potential reconstruction. This is a carefully mapped-out process which can involve multiple specialties including plastic surgeons, orthopaedic surgeons, vascular surgeons, and podiatrists. As the wound expert, the plastic surgeon is well placed to manage these wounds.
Return to function for extremity wounds is variable and depends on the extent and tissues involved. In a pure soft tissue wound, return to full weight bearing for the lower extremity can occur in about 3 to 4 weeks after surgery. If there is bony fracture fixation or reconstruction required, full weight bearing may take up to 2 to 3 months to occur, to allow for full healing of the bone.