Management of diabetic foot with toe gangrene and severe · Management of diabetic foot with toe gangrene and severe arterial disease Ahmed Kayssi, MD MSc MPH FRCSC CWSP Vascular

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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!

Final Take Home Message!

Please keep in touch!

Email: ahmed.kayssi@sunnybrook.ca

Twitter: @ahmedkayssi

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

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