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Abstract

Diabetic foot (DF) is a complication resulting from long-term, inadequately treated diabetes mellitus (DM). The foundation
of diabetic foot lies in the presence of chronic complications on the foot associated with DM. Significant challenges in
addressing the complex issue of DF pose a challenge to better understanding and optimizing DF treatment. Diabetes
leads to a reduction in blood flow in arterial blood vessels, resulting in decreased perfusion to all tissues. This leads to
reduced vitality and functionality of all tissues, particularly noticeable in the feet, which are the most distal parts of the
body exposed to load. Changes in DF manifest with diverse clinical presentations, ranging from local to systemic, and vary
in extent from subtle and barely noticeable to gangrene. Diagnosis is generally straightforward and based on medical
history, clinical presentation, laboratory testing, and radiography. Treatment can be preventive, primarily through patient
education about possible diabetes complications and lifestyle changes. Treatment for existing foot changes is based on foot
offloading, medications, and surgical intervention in cases of significant complications, deformities, necrosis, and infection.
Surgical treatment can be preventive and reconstructive. Preventive surgical treatment involves establishing better
anatomical relationships to evenly distribute pressure on soft tissues. Reconstructive surgical treatment encompasses
all procedures and surgical techniques aimed at preserving anatomical integrity, function, and reducing disability. A
multidisciplinary approach to addressing the complex issue of DF yields the best results and significantly reduces mortality
and the need for radical surgical interventions such as below-knee and above-knee amputations. Timely intervention
with appropriate medication and surgical therapy, along with continuous monitoring, is essential to avoid additional
complications, shorten treatment duration, and reduce the extent and radical nature of surgical procedures.

Keywords: diabetes mellitus, diabetic foot, surgical treatment, ulcerations, Charcot neuroarthropathy

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REVIJALNI RADOVI Galenika Medical Journal, 2023; 2(8):35-42. 41