Soft Tissue and Osseous Substitutes for the Diabetic Foot.

Several soft tissue and osseous substitutes have become widely available for consideration in diabetic foot and ankle reconstruction. Although autogenous skin and bone grafts remain the gold standard, the diabetic foot often presents with challenging clinical scenarios in which these options are limited or contraindicated. Selection of the appropriate substitute depends on the patient's medical status, type and extent of soft tissue and bone loss, and expected function of the given site.

The "1-4-4-2" Model for the Diabetic Foot Team.

The cause of diabetic foot complications is often multifactorial; therefore, expertise from multiple surgical and medical specialties is warranted for improved clinical outcomes. Teamwork should be carefully coordinated with strategic planning and treatment should be adaptable to the given clinical scenario. This article describes the formation and interplay of an effective multidisciplinary team for the treatment of the diabetic foot analogous to that seen in elite team sports.