01
Urgent Assessment & Imaging
First StepDoppler ultrasound, X-rays, blood tests, and infection swabs within 24 hours. Identifies the extent of infection, blood supply, and bone involvement to guide the right intervention.
Limb Salvage & Advanced Wound Care
DIABETIC FOOT& GANGRENE CARE
Professor Dr. S.M.G. Kibria
Save the limb · Save the life · 35,000+ procedures
- FRCS (England)
- FRCS (Glasgow)
- FRCS (Edinburgh)
- FRCS (General)
- MSc (Leeds)
- MBBS (DMC)
The Procedure
What Is Diabetic Foot Care?
A multi-disciplinary, limb-first approach to diabetic foot ulcers and gangrene — combining revascularisation, debridement, advanced dressings, and lifelong prevention.
Diabetic Foot Surgery
Combined vascular & wound care to save the limb
Diabetic foot disease is the leading non-traumatic cause of lower-limb amputation worldwide. Three factors combine: nerve damage (reduced sensation), poor circulation, and increased infection risk. Modern limb-salvage care combines revascularisation (angioplasty or bypass), debridement, targeted antibiotics, and advanced wound dressings — saving more than 80% of feet that previously would have been lost.
- Multi-teamSurgery, podiatry, endocrine
- 80%+ salvageWith early treatment
- 24-hourUrgent assessment
- LifelongFoot care education
Warning Signs
When You Need Urgent Care
Diabetic foot complications can deteriorate within hours. Any of the following warrant assessment within 24–48 hours.
- Non-healing foot ulcer — any wound that hasn't healed in 2 weeks.
- Redness, warmth, or swelling — signs of cellulitis or deeper infection.
- Black or dark discolouration — toes, foot, or skin patches — possible gangrene.
- Foul-smelling drainage — pus, discharge, or unpleasant odour from a wound.
- Cold or pale foot — sign of poor blood supply, often with absent pulses.
- Numbness or tingling — diabetic neuropathy — increases injury and ulcer risk.
- Sudden severe foot pain — especially at night — possible critical ischaemia.
- Fever or chills — with any foot wound — sign of systemic infection.
Treatment Approach
Stages of Diabetic Foot Care
Prof. Kibria applies a step-by-step approach: assess, revascularise, debride, dress, and rehabilitate.
02
Revascularisation
Restore Blood FlowAngioplasty (balloon and stent) or surgical bypass restores blood supply to the foot — without good blood flow, no wound will heal. The single most important step in limb salvage.
03
Debridement & Wound Care
HealingSurgical removal of dead tissue, targeted antibiotic therapy, advanced dressings (negative-pressure wound therapy, antimicrobial dressings), and off-loading footwear to allow healing.
04
Lowest-Level Amputation (if unavoidable)
Last ResortWhen tissue death is irreversible: amputation at the lowest possible level (a single toe, ray amputation, or transmetatarsal) to preserve function and weight-bearing.
After Treatment
Recovery & Long-Term Care
Diabetic foot recovery is a marathon, not a sprint. The team approach continues for life.
Week 1 — Admission & Stabilisation
IV Antibiotics & Revascularisation
Hospital admission. IV antibiotics, debridement, and revascularisation. Blood sugar control optimised. Wound assessed and dressed daily.
Weeks 2–4 — Discharge & Dressings
Home Wound Care
Regular dressing changes (initially daily, then 2–3 times weekly). Off-loading footwear or cast. Oral antibiotics. Tight glycaemic control.
Weeks 4–12 — Wound Healing
Granulation & Closure
Wound contraction, granulation tissue, eventual closure. Some wounds need skin grafting; others heal by secondary intention. Multidisciplinary review every 2 weeks.
Months 3–6 — Rehabilitation
Return to Walking
Custom diabetic footwear, gait retraining, gradual return to normal activity. Education on daily foot inspection and warning signs.
Lifelong — Prevention
Daily Foot Inspection
Lifelong diabetic foot care: daily foot self-inspection, well-fitted shoes, regular podiatry, tight diabetes control, immediate report of any new issue.
Can a diabetic foot be saved?
Yes — early, aggressive, multi-disciplinary care saves more than 80% of diabetic feet. Limb salvage rates depend on early presentation, prompt revascularisation, infection control, and wound care.
Is gangrene always treated with amputation?
No. Many cases respond to revascularisation, debridement, and antibiotics. Amputation is reserved for irreversible tissue death — and at the lowest possible level to preserve function.
How quickly should diabetic foot symptoms be treated?
Urgently — within 24–48 hours. Diabetic foot infections deteriorate rapidly. Delay is a major risk factor for limb loss.
What is the recovery from limb-salvage surgery?
Variable. Simple debridement: weeks of dressings. Major revascularisation: 1–2 weeks hospital, gradual walking over 6–12 weeks. Lifelong diabetic foot care continues.
How do I know if I have a diabetic foot problem?
Warning signs: non-healing wound, redness, swelling, drainage, bad smell, dark skin, numbness or tingling, sudden severe pain. Diabetics should self-inspect daily.
What causes diabetic foot complications?
Three factors: nerve damage (neuropathy), poor blood circulation, and increased infection risk. Poorly controlled blood sugar accelerates all three.
Who is the best diabetic foot surgeon in Bangladesh?
Prof. Dr. S.M.G. Kibria — FRCS x4, GMC Registered, 18 years UK consultant practice, 35,000+ surgeries — is one of Bangladesh's most experienced surgeons in diabetic foot care and limb salvage.
Where is diabetic foot care provided in Dhaka?
Lake View Clinic — House-05, Road 79, Gulshan-2. SMG Kibria Foundation — Ta-97, Middle Badda, Gulshan. Call +880 1711-402445.
Take the First Step
World-Class Surgical Care, Right Here in Dhaka
Whether you need a surgical consultation, a second opinion, or emergency care — Professor Dr. SMG Kibria and his team are here for you.