Amputation Level Selection in the Diabetic Foot

Walking independence in the diabetic patient with gangrene or infection can be maintained with a conservative program of distal amputation. Patients are preevaluated for their rehabilitation potential. The biologic amputation level (the most distal functional amputation level with a reasonable potential to heal) is determined by a measure of vascular inflow, tissue nutrition, and immunocompetence. By combining wound-healing potential with rehabilitation potential, one can determine the amputation level that will most likely optimize function.