Diabetes Research and Treatment: Open Access Received: Oct 07, 2014 Accepted: Oct 09, 2014 Published: Oct 11, 2014 Pramod Kumar Consultant Plastic Surgeon, King Abdulaziz Specialist Hospital, Skakak, AlJouf, Saudi Arabia The increasing rate of diabetes all around the globe is a major concern today. As far as limb amputation is concerned, diabetes around the globe results in one major limb amputation every 30 seconds, over 2500 limbs lost per day. In India alone, 40,000 amputations are performed annually [1]. In Saudi Arabia- gradually becoming a major Problem [2]. The CDC estimates that 23.6 million Americans currently have diabetes-7 percent of the U.S. population-up from 18.2 million in 2003 [3]. Diabetes- related amputations cost approximately three billion dollars per year ($38,077 per amputation procedure) [4, 5]. With the rise of diabetes diagnoses, there is also an expected rise in the number of amputees. CDC report finds large decline in lower-limb amputations among U.S. adults with diagnosed diabetes [http://www.cdc.gov/media/releases/2012/p0124_lower_limb.ht ml]. The age-adjusted rate of non-traumatic lower limb amputations was 3.9 per 1,000 people with diagnosed diabetes in 2008 compared to 11.2 per 1,000 in 1996. Improvements in blood sugar control, foot care and diabetes management, along with declines in cardiovascular disease, are likely to have contributed to the decline in leg and foot amputations among people with diagnosed diabetes. This encourages us for multidisciplinary care to save limb in place of amputate and replace with artificial limb. Apart from control of diabetes and prevention of ulcer by foot care, there is needed to emphasize on early treatment of ulcer under cover of newer dressing methods. Newer dressings like moist wound healing, conventional continuous negative pressure dressing, calcium alginate dressing and silver impregnate dressings have promising results, but the treatment cost increases sharply. Combination of moist healing and intermittent negative pressure dressing like Limited Access Dressing (LAD) [6, 7] appears to be a better economical tool for limb salvage. Problems of conventional surgical approach When following ulceration, infection and tissue destruction (necrosis/ gangrene) debridement is done, along with dead tissue variable loss of amount of viable tissue in the process cannot be avoided. This may expose vital structures (tendon, bone, joint etc) and lead to desiccation of exposed tissue on conventional dressing methods. Vicious cycle of Re- debridement and tissue necrosis may set in that will lead to minor/major amputations. Hence a logical approach may be ultraconservative debridement and protection of further necrosis by some means e.g. moist dressing. Ultraconservative approach of LAD http://dx.doi.org/10.14437/DRTOA-1-108 Editorial Pramod Kumar, Diabetes Res Treat Open Access 2014, 1:2 How Limited Access Dressing is an Effective Tool for Limb Salvage in Diabetic Patients? * Corresponding Author: Pramod Kumar, Consultant Plastic Surgeon, King Abdulaziz Specialist Hospital, Skakak, AlJouf, Saudi Arabia; E-mail: pkumar86@hotmail.com Copyright: © 2014 DRTOA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, Version 3.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Volume 1 • Issue 2 • 108 www.aperito.org