Everyone. I am Dr. Premkumar, diabetic foot surgeon.This video is mainly for the young surgeon as well as postgraduate students who want to deal with the diabetic foot to start with. If they plan any surgical procedures, they should have a clear view of how they start with an incision. So in a diabetic foot, the infection tends to spread across particular lines. I’m going to tell you about that one.
Suppose, for example, if it is a tropical first meta torsal also and if it is infected, it tends to spread across the underlying tendon. Say, for example, for this ulcer site, it will probably spread across the flux are tunnel-like this tendon. The incision should be planned vertically so as to if it’s required, you can incision extend further also, or else if you want to give a very good lateral clearance, you can do a CRISPR sensation. Also, you have to trace the tenant. That is foremost important.
You have to plan any incision like that so that you can trace the tendon how much you require. If you come for tendant all the tenants will travel in this direction towards the flux. This is fluxed tunnel. If you cut the flux a tunnel, you should be careful not to injure your posteriorly, which lies in the anatomy of the vessels is also the doctor should know so that they will be very careful once they come at that point. Suppose it is an ulcer at the two sides.
If any surgeons want to deprive that one, the digital vessel should be taken care of if you deliberate the website of the digital vessel. If they injure, there is vascular transfer compromise, and it may turn into gangrene also. And if it comes for incision again, one more point. I want to tell you the incision should be a lengthy incision so as to give a very good thorough debridement.
If you put a small incision and if you don’t adequately debrief, your patient will come again, and you need to go for second safety brightness. So usually, it is better to avoid that one. And the anatomy of the underlying muscular-skeletal structure as well as tendinous origin. Also, it is important a plan for shelf amputation. If it is a forefoot, it is okay.
Suppose you go for midfoot or high midfoot. Sometimes you may tend to cut this anterior tendon, so then the foot mostly will go for equines to correct that on a table you can lengthen this sensation. No, you see this one. You need to lengthen this TBL by zed plastic; Thereby, you can reduce the equine deformity of this thing even though it may seem to be minor. These are very important when it comes to a practical aspect of diabetic food and everything.
The consequences and complications, as well as the probable complication. All these things need to be informed to the attendar rotation by standard. Well, before you plan any surgical procedure and more than the coverage of the wound that either it could be a grafting or it could be a black cover. All these things you need to tell that one as a second stage procedure. Sometimes it is better to do as a second stage procedure in an infected one all these things you need to tell well before so the patient will be ready for everything and the duration and probably recovery also if you speak to the patient attender, your practice will be comfortable, and the patient won’t have many questions about that. So thanks for watching this simple video.