Diabetic Foot Care: When Orthopaedic and Vascular Surgery Become Necessary

When do diabetic foot complications require specialist care in Pune?

Diabetic foot complications require specialist evaluation when a wound does not heal within two to four weeks, when there is signs of infection, bone involvement, or reduced blood flow. Deccan Hardikar Hospital in Pune provides orthopaedic and vascular surgical care for diabetic foot conditions at its Shivajinagar centre, offering a coordinated approach to limb preservation.

Diabetes can damage both the nerves (peripheral neuropathy) and blood vessels (peripheral arterial disease) in the feet. This combination makes even minor cuts or pressure sores dangerous. Early specialist review — from an orthopaedic surgeon, a vascular surgeon, or both — significantly improves outcomes and reduces the risk of amputation.

What are the warning signs of a diabetic foot ulcer?

Recognising early warning signs allows treatment to begin before complications escalate. Seek specialist review promptly if you notice any of the following:

• Non-healing wound or sore — any break in the skin on the foot or lower leg that has not closed within two weeks
• Redness, warmth, or swelling — signs of localised infection or inflammation
• Discharge or foul odour — pus or unusual fluid from a wound indicates active infection
• Blackened or darkened skin — discolouration around a wound may indicate tissue death (gangrene)
• Numbness or loss of sensation — inability to feel pain, heat, or pressure in the foot
• Cold or pale foot — reduced skin temperature or colour change suggests poor blood supply
• Fever with a foot wound — systemic infection spreading from a diabetic foot ulcer is a medical emergency
• Bone visible in the wound — indicates osteomyelitis (bone infection) and requires urgent surgical assessment

When does a diabetic foot problem require surgery?

Not every diabetic foot ulcer requires surgery, but certain clinical findings make surgical intervention necessary. The following table outlines the thresholds at which orthopaedic or vascular surgical review becomes essential:

If any of the above findings are present, do not delay. Use the booking form on this page to request an urgent specialist appointment.

How do orthopaedic and vascular surgeons work together for diabetic foot?

Diabetic foot care often requires two surgical disciplines working in parallel. Neither specialty alone addresses every aspect of the condition.

• Orthopaedic surgeons manage bone and joint complications — including Charcot foot reconstruction, removal of infected bone (sequestrectomy), correction of deformities that cause pressure ulcers, and stabilisation of fractures in neuropathic limbs. Deccan Hardikar Hospital's orthopaedic and sports injury team is experienced in complex foot and ankle conditions.
• Vascular surgeons restore blood supply to the foot through procedures such as peripheral angioplasty, arterial bypass grafting, or endovascular stenting. Without adequate circulation, wounds cannot heal regardless of wound-care quality.
• Combined case management — in complex cases, both teams assess the patient together. Vascular revascularisation is typically performed first to ensure the foot has sufficient blood supply before orthopaedic reconstruction proceeds.
• Supporting disciplines — endocrinology (blood glucose optimisation), infectious disease (antibiotic selection), and rehabilitation medicine all contribute to a complete care pathway.

Deccan Hardikar Hospital in Pune brings orthopaedic, vascular, and surgical disciplines under one roof, enabling coordinated management without the need to transfer between facilities.

Can a diabetic foot ulcer heal without amputation?

Many diabetic foot ulcers can heal without amputation when blood supply is adequate, infection is controlled, and offloading (pressure relief) is maintained consistently. The key factors that determine whether limb preservation is possible include:

1. Blood flow status — if arterial disease is present, revascularisation must be achieved before healing can occur. Vascular surgery or endovascular intervention restores circulation to the wound bed.
2. Infection control — superficial infections respond to antibiotics; deep or bone infections require surgical debridement to remove non-viable tissue.
3. Blood glucose management — poorly controlled diabetes impairs immune response and wound healing. Optimising HbA1c is a non-negotiable part of treatment.
4. Offloading — total contact casting or specialised footwear removes pressure from the ulcer site, allowing tissue repair.
5. Wound care — regular debridement, appropriate dressings, and monitoring for signs of deterioration.

Amputation is reserved for cases where gangrene is irreversible, infection is life-threatening and cannot be controlled by other means, or blood supply cannot be restored. A specialist assessment is required to determine which pathway is appropriate for each individual patient.

For patients who have experienced trauma to a diabetic foot, trauma care at Deccan Hardikar Hospital is available around the clock.

What daily foot care routine should a diabetic patient follow?

A consistent daily routine reduces the risk of ulcers forming in the first place. The following steps are recommended for all patients with diabetes:

• Inspect both feet every day — check the soles, between the toes, and around the heels for cuts, blisters, redness, or swelling. Use a mirror or ask a family member if vision is limited.
• Wash feet in lukewarm water — test water temperature with your elbow, not your foot, to avoid burns caused by neuropathy.
• Dry thoroughly, especially between the toes — moisture between toes promotes fungal infection and skin breakdown.
• Moisturise the soles and heels — but avoid applying cream between the toes.
• Trim nails straight across — never cut into the corners; file sharp edges gently.
• Wear well-fitting, cushioned footwear at all times — never walk barefoot, even indoors.
• Check inside shoes before putting them on — remove any objects or rough seams that could cause pressure points.
• Never self-treat corns, calluses, or ingrown nails — seek podiatric or specialist review instead.

How does Deccan Hardikar Hospital support diabetic foot patients in Pune?

Deccan Hardikar Hospital, located at 1160/61, University Road, Shivajinagar, Pune 411005, is a NABH Pre-Accredited superspeciality hospital with five decades of surgical experience across Western Maharashtra. The hospital's orthopaedic and vascular surgery teams manage diabetic foot cases within a broader multispeciality environment that includes nephrology, endocrinology support, emergency and ICU services, and a histopathology laboratory — all on a single campus.

For diabetic foot patients, this means:

• Orthopaedic assessment for bone, joint, and deformity-related complications — including joint care and foot reconstruction
• Vascular surgery for peripheral arterial disease and revascularisation
• Plastic surgery support for complex wound closure and skin grafting
• On-site emergency and ICU care for acute presentations
• Transparent cost structures and patient-centric care pathways

Patients from across Western Maharashtra are referred to Deccan Hardikar Hospital for complex orthopaedic and surgical cases. The hospital's referral network and multispeciality infrastructure make it a practical choice for diabetic foot care that requires more than one surgical discipline.