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An extract of the brochure „The diabetic foot syndrome“ by Dr. med. Karl Zink


When is it time for an amputation?

Like an iceberg, concerning wounds you only can see the tip of them. The damage of the tissue mostly is even more serious than you might image from seeing the outside. Therefore often joints are being disclosed by an open wound, bones are corroded or the infection has been spread all over the foot via the tendons. Those structures are badly supplied with blood and as a matter of that some infection can´t be eliminated with antibiotics.


An amputation only should be done when the circulation is okay, has been improved and can´t be improved any further. Only in very few cases an amputation has to be done right away because of an infection.


Infections in bones and open joints are with little prospect for success, in particular by the time the part of the soft tissue around the wound is seriously affected and a normal circulation doesn´t exist anymore.


By facing an existing wound and bad circulation, an expert may say immediately if the tissue can heal or not. If the wound has black edges or a grey color in the affected area, there is a poor chance for the wound to heal. Those parts of the tissue have to be totally removed. Some clinics use the modern method of removing the dead and sore tissue and temporarily closing the wound with a vacuum sealing. After some days a second operation takes place to re-examine the tissue and finally sealing the wound in case the wound has been healed and recovered and is free of infection.


Aches can´t be controlled totally, even not with modern medication; this as well can be a reason for an amputation.