[Diabetic foot: is preventive surgery possible?]

The diabetic foot and its complications are in many cases leading to minor- or major amputations. If macro-vascular diseases are excluded, most of the patients are in a conservative follow-up. Surgeons are only involved if infections occur. In this series of 34 patients and surgery on 39 feet 2/3 consisted in incision/debridement and/or partial ray resections. Nevertheless 1/3 of the surgery could be considered as prophylactic. This means performing surgery at a state of "hyperceratosis" of the foot, a sign of high pressure areas. Of these patients all wounds healed per primam and no additional footwear was necessary. We believe that teamwork, especially with the surgeon, should lead to an early diagnosis of diabetic foot disorders. If necessary surgery should be performed in order to avoid the mal perforans and by this avoiding infection or amputation.