Emergent surgery includes conditions that require immediate surgical intervention. These patients generally present to the emergency room/casualty department with serious foot infections. It is important to emphasize that signs of systemic toxicity are not always present and clinical findings may be subtle. Patients may or may not be febrile; they may or may not have an elevated white blood cell count: however, their diabetes is most often out of control. These patients require immediate hospitalization and work-up for infection and surgery. Depending upon the presentation, surgical treatment may include: incision and drainage of pus, exploration of wounds, debridement of necrotic soft tissue and bone, revascularization and local amputation of the foot. The urgency and aggressiveness of surgical care is determined by the nature of the presentation and by the clinician's familiarity with the diabetic foot. Limb-threatening conditions in seriously ill patients require immediate medical and surgical triage.
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