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Management of diabetic foot with toe gangrene and severe
arterial disease
Ahmed Kayssi, MD MSc MPH FRCSC CWSP
Vascular Surgeon and Wound Care Physician
Assistant Professor, Department of Surgery, University of Toronto, Canada
Disclosure
Speaker name:
...................Ahmed Kayssi.......................................................
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest
Case
• 65 male diabetic, smoker, hypertensive, hyperlipidemia, atrial fibrillation, peripheral neuropathy.
Case
• Duplex ultrasound revealed evidence of proximal AT occlusion and tight TP trunk stenosis.
• Patient taken to the cath lab, challenging lesions…
Case
What about the toes?
Two weeks later…
Back to the OR…
Post-op week 1 (Last week…)
Take Home Message 1
Clinical outcomes more important than anatomical outcomes
Take Home Message 2
Ensure adequate wound moisture balance
Take Home Message 2
Ensure adequate wound moisture balance
- AMD: Polyhexamethylene Biguanide
Take Home Message 3
Pay attention to the surrounding skin
Take Home Message 3
Pay attention to the surrounding skin
- Vaseline
- Uremol (Urea 20%)
- Betaderm (Betamethasone Valerate)
Take Home Message 4
Wound healing is impaired if the leg is edematous
Take Home Message 4
Wound healing is impaired if the leg is edematous
Take Home Message 5
• Get involved in wound care!
Management of diabetic foot with toe gangrene and severe
arterial disease
Ahmed Kayssi, MD MSc MPH FRCSC CWSP
Vascular Surgeon and Wound Care Physician
Assistant Professor, Department of Surgery, University of Toronto, Canada
