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Treating Chronic Diabetic Foot Ulcers by Minimally Invasive Surgery
Diabetic foot ulcers (DFUs) are one of the most common complications of poorly managed diabetes. These slow-healing wounds can become infected without treatment, increasing the risk of potentially severe complications. The good news is that minimally invasive surgery offers a promising treatment option.
At The Foot Institute in Shreveport and Natchitoches, Louisiana, expert podiatrist Angelo Morreale, DPM, and our team specialize in minimally invasive DFU surgery.
Read on to learn why DFUs develop, the different types of minimally invasive surgery that can treat them, and how surgery can help keep your lower extremities healthy.
What are chronic diabetic foot ulcers (DFUs)?
Chronic DFUs are long-lasting open wounds that form due to poorly managed or untreated diabetes. Diabetes is a group of chronic diseases that affect your body’s ability to regulate blood sugar (glucose). Too much glucose in your blood can slow circulation to your lower extremities, permanently damage your nerves, and affect your body’s healing process.
DFUs typically heal within a few months and often improve with at-home treatments and healthy lifestyle changes. When an ulcer persists for three months or longer, however, it’s considered chronic. Chronic DFUs are harder to treat and increase the risk of infection and other complications.
Traditional DFU treatments and their limitations
Minor DFUs typically respond well to traditional diabetic foot care treatments, such as offloading (reducing pressure on the affected foot through footwear or specialized devices), antibiotics to clear infection, and professional wound care.
Given that chronic DFUs are less likely to improve with these approaches, they’re more likely to become reinfected and may even require amputation. In these instances, minimally invasive surgery may be recommended to improve circulation and reduce your risk of complications.
Minimally invasive surgery: 3 new approaches for chronic DFUs
Dr. Morreale and our team specialize in several types of minimally invasive surgery for DFUs. Depending on the location, size, and severity of your persistent ulcer, they could recommend:
1. Minimally invasive wound debridement
When a DFU becomes infected, it can cause the surrounding tissue to break down, increasing the risk of bacterial overgrowth, gangrene, and amputation.
Minimally invasive wound debridement removes dead or infected tissue from in and around the wound using a scalpel or other precision surgical tools. This process reduces bacterial load, prevents further tissue damage, and creates a healthier environment for healing.
2. Percutaneous flexor tenotomy
We might recommend this minimally invasive surgery if you have a DFU on one or several toes. This procedure is particularly beneficial for toe deformities, such as hammertoe and mallet toe.
During tenotomy surgery, we make a small incision in your affected toe and use specialized surgical tools to release the flexor tendon. This prevents your toe from bending abnormally, reducing pressure on the ulcer and promoting healing.
3. Vascular surgery
Sometimes, DFUs are exacerbated by poor circulation. If lifestyle changes, like quitting smoking and exercising regularly, don’t lead to significant improvements in blood flow, we may recommend a vascular procedure.
For example, an atherectomy uses specialized tools to remove plaque — a mixture of fat, cholesterol, and calcium — from affected arteries, improving lower extremity circulation.
Another minimally invasive procedure that can help DFUs heal is balloon angioplasty and stenting. During this procedure, a balloon is inflated inside a narrowed or blocked blood vessel to open it up. A mesh device called a stent is then placed to help keep the vessel open and improve circulation to the affected foot.
Request a minimally invasive surgery consultation today
DFUs can increase your risk of various serious complications, including amputation. Luckily, minimally invasive surgery can prevent these worst-case scenarios and speed up healing.
To schedule an appointment with Dr. Morreale and our caring team at The Foot Institute, call your nearest office in Shreveport or Natchitoches, Louisiana, today.