Diabetic Ray Amputation Wounds Managed With Local Flap Surgery and Negative Pressure Wound Therapy: A Case Series.

A new surgical technique for ray amputation of the diabetic foot is described. The procedure provides soft tissue reconstruction using a local flap in combination with negative pressure wound therapy to close these wounds safely and effectively. This article reports on 12 patients treated with this technique in a Tertiary Hospital/General Hospital in Singapore and compares their outcomes to those of 12 comparative cases from neighbouring institutions under the same health group who received conventional dressings. The new technique led to a higher number of healed wounds (12 vs. 4) and a shorter median time to healing (46.5 vs. 196.5 days). No major amputation or further minor amputation of the target limb occurred in the group treated with the new technique, whereas one major amputation and two further minor amputations took place in the comparison group. Our results suggest that the new technique is promising in this diabetic population with concurrent comorbidities.