Diabetic foot reconstruction remains to be difficult. Major vessels in diabetic foot are often calcified and inadequate as a recipient. As we search for new ways to increase the success for reconstruction, “supermicrosurgery concept” using small branches or perforators from other collateral vessels with an adequate pulse may be an alternative method. The multidisciplinary team approach is essential to build a good foundation for reconstruction, along with the recent new supermicrocuergery approach we will be presenting on how we push the boundaries for success in diabetic foot reconstruction. Furthermore, we are now addressing nerve related challenges after amputation using various reconstructive methods. The quest to provide better care for diabetic foot patients continues.

In this presentation, we will discuss how classical approach using microsurgery is made and then how to approach ischemic diabetic foot using supermicrosurgery concept. Furthermore, we will exam the impact of thinking orthoplastic approach to improve the function of the foot as well as to prevent furthermore breakdown by understanding kinetics. Finally, will briefly mention on the progress of the nerve surgeries minimizing phantom pain and neuroma related pain.

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