Vascular Control

It is important to explore the possibility of revascularization of the infected neuroischemic foot as improvement of perfusion will help to control infection as well as to promote healing of the ulcer and wounds if operative debridement is carried out. Revascularization may be carried out by angioplasty or arterial bypass. When there is considerable tissue destruction it is necessary to restore pulsatile blood flow (77). In these circumstances, distal arterial bypass, in particular to the dorsalis pedis artery, which may be relatively spared, has been established as a valuable procedure in conjunction with surgical debridement, adjunctive plastic surgery and antibiotic therapy (78).

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