In diabetic foot, which amputation is contraindicated:
Ref: Bailey & Love's Short Practice of Surgery 25th Edition Pages 915-917Explanation:For any amputation to heal the local residual stump needs good vascularity, in Syme's amputation it is essential to preserve the blood supply to the heel Bap by meticulous clean dissection of the calcaneus.The tibia and fibula are sectioned as low as possible to the top of the joint.This type of procedure is rarely suitable for severely ischemic athermanous limbs because of the poor healing of the heel flap.Hence not suitable for diabetic foot so it is contraindicatedIndications for amputation remember "3D"Dead limbGangreneDeadly limbWet gangreneSpreading cellulitisArteriovenous fistulaOther (e.g. malignancy)'Dead loss' limbSevere rest painParalysisOther (e.g. contracture, trauma)Figure: Types of Amputations* A ray amputation is done for digital gangrene of the toes where incision is like a ray of sun , Forefoot amputation is nothing but a transmetatarsal amputation
Ray amputation
Forefoot amputation
Syme's amputation
Below knee amputation
Amputation