[Medical and surgical management of septic diabetic foot]

Infected wounds in diabetic patients are still frequent and the main cause of amputations. The experience of 180 patients admitted for foot lesions between june 1988 and september 1993 shows us the importance of combined medical and chirurgical cares. Non invasive vascular evaluation is reliable and often sufficient for preoperative vascular assessment. Total excision of infected and necrotic tissues is essential for the control of septic conditions. Conservative surgery can be considered a possibility as atypic amputations and adapted footwear may allow quick recovery and early walking. Resigned attitudes and pejorative outlooks are out-of-date, when faced with a diabetic foot problem. Optimal metabolic control and full preoperative assessment guide surgical possibilities.