Surgical Treatment of Infected Wounds
Deep, spreading foot infections need urgent treatment. Surgical cleaning is the key step in controlling infection and saving the foot.
Infection in a diabetic foot ranges from mild wound inflammation to deep tissue abscesses and bone infection. Because the immune response can be weaker and circulation poorer in people with diabetes, infections can spread quickly. In deep, spreading infections antibiotics alone are not enough; surgical cleaning is needed.
Signs
- Spreading redness and warmth around the wound
- Swelling and tightness
- Pus or foul-smelling discharge
- Blue or black discolouration of the foot
- Fever, weakness and unexpectedly high blood sugar
Diagnosis
The extent of the infection, any abscess and the circulation are examined. Blood tests, wound cultures, X-rays and MRI show how deep the infection goes and whether it reaches the bone. Vascular studies are done if poor circulation is suspected.
Surgical treatment
Debridement
Infected and dead tissue is removed surgically. The aim is to remove the source of infection and prepare the ground for healthy tissue to heal. The procedure is repeated if needed.
Abscess drainage
Pus collected in the tissue is drained and the abscess cavity cleaned.
Surgery for bone infection
If the infection has reached the bone, the infected bone is removed.
Limited amputation
For toes or parts of the foot damaged beyond saving, a limited amputation may be needed to preserve the rest of the foot. The main aim of treatment is to keep as much tissue as possible.
After surgery
Antibiotics are continued according to culture results. Wound care, vacuum-assisted closure (VAC) when needed, and offloading are applied. Blood sugar control and improving circulation are inseparable parts of treatment. Once the wound heals, special shoes and insoles are recommended to prevent new wounds.
Assessing circulation
When the foot does not get enough blood, even well-performed surgical cleaning may not lead to healing. Checking pulses, Doppler ultrasound and, when needed, vascular imaging are therefore part of the treatment plan. In patients with narrowed arteries, improving blood flow through vascular surgery or interventional radiology raises the chance of healing.
A team approach
Treating diabetic foot infections requires orthopaedics, infectious diseases, vascular surgery, endocrinology and wound care nursing to work together. This team approach plays an important role in reducing the risk of limb loss.
Frequently asked questions
Can an infected wound heal with antibiotics alone?
Superficial infections can heal with antibiotics. But if there is an abscess, dead tissue or bone infection, the infection cannot be controlled without surgical cleaning.
Does surgery mean I will lose my foot?
No. The aim of surgical cleaning is to stop the infection and save the foot. Early intervention lowers the risk of limb loss.
How long does treatment take?
It depends on the extent of the infection. Wound care and antibiotics after surgery can last several weeks.
How long will I stay in hospital after surgery?
It depends on how severe the infection is, the procedure and blood sugar control. Some patients go home within a few days, while severe infections may need a longer stay.
What can I do to prevent infection?
Checking your feet every day, taking even small wounds seriously, controlling blood sugar well and wearing suitable shoes are the most effective measures.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.