ObjectivesTo evaluate the functional outcome, morbidity, and viability of foot salvage in diabetic patients.Materials and methodsThis prospective case series was conducted from March 2007 to December 2012 at the department of surgery Pakistan Ordnance Factories Hospital, Wah Cantt, Pakistan. 123 males and 26 female patients were included in the study. All the patients were treated after getting admitted in the hospital and wounds were managed with daily dressings, nursing care and debridement of necrotic tissue with adequate antibiotic coverage.ResultsIn total, 149 patients (mean age: 56±7.52 years) with 171 amputations were included in the study. The mean duration of diabetes mellitus (DM) was 9±4.43 years. Ninety-seven percent of the patients were diagnosed with type 2 DM. Wound debridement was performed under general anesthesia in 48 (33.2%) patients, whereas local anesthesia was used for the rest of the patients after having good glycemic control and improvement in general health. The most common pathogen isolated from the infected wounds was Staphylococcus aureus in approximately 46% cases. Regarding the types of amputation, partial toe amputation was performed in 21 (12.2%) cases, second-toe amputation in 60 (35%) cases, hallux amputation in 41 (24%) cases, multiple toe amputations in 29 (17%) cases, bilateral feet involvement was observed in 16 (9.3%) cases, and transmetatarsal amputation was performed in 4 (2.3%) cases. The wounds healed well except in 19 cases where amputation had to be revised to a more proximal level. Thirty-nine patients died during the study period: 3 died of wound-related complications and 36 died of systemic complications.ConclusionWith the ever-increasing epidemic of DM, the number of patients with diabetic foot ulcers has also significantly risen. Early surgical management with good glycemic control and foot care with close monitoring can decrease amputations and thus foot salvage can be successfully achieved.

Assess results of small ventral hernia (UH, PUH) and diastasis recti repair during H shape mesh hernioplasty and Tummy Tuck "abdominoplasty" regarding operative duration, intraoperative blood loss, length of hospital stay, length time return to work and post-operative complications. The present prospective study included 60 patients with UH, PUH hernia and diastasis recti. A mean Age of 50.77 ± 9.504 years. 30 patients underwent H shape mesh hernioplasty Group 'A' and 30 underwent standard Tummy Tuck "abdominoplasty" Group 'B'. From 2019 to 2020. And the patients followed for 8_14 months. In group 'A' the main operative time 45.17 ± 3.592 min, main intraoperative blood loss 75ml, insert SC drain in 93% removed after mainly 1.2 day, main postoperative pain 2.9 ± 0.923, length of hospital stay 1.07 ± 0.365 days and main time till return to work 7.33 ± 1.373 days. Post-operative Complications included seroma formation (3.3%), hematoma (6.7%), wound infection (6.7%), recurrence (3.3%) to date and 100% of patient was satisfied. In group 'B' the main operative time 88.5 ± 8.823 min, main intraoperative blood loss 250 ml, insert SC drain in 100% removed after mainly 14.93 ± 2.42 day, main postoperative pain 5.4 ± 0.648, length of hospital stay 3.4 ± 1.221 days and main time till return to work 23.1 ± 3.872 days. Post-operative Complications included seroma formation (20%), hematoma (10%), wound infection (6.7%), recurrent hernia (3.3%) and divarication recurrence (10%) to date and 63% of patient was satisfied. H shape mesh repair technique was safe, easy, fast and early return to work and superior to tummy tuck technique in small PUH with diastasis recti repair at less operative (time, blood loss) and less Post-operative (pain, infection, hematoma, seroma, hospital stay and return to work).