https://jvsgbi.com/tenotomy-for-diabetic-foot-ulcers-a-scoping-survey-of-current-practice/
Diabetes is very common and one of the major problems is foot ulcers. Many foot ulcers fail to heal. Tenotomy describes cutting tight foot tendons to redistribute pressure in the foot. This may help ulcers heal faster and stop them coming back. This study aims to see who uses tenotomy and how it is performed.
The study was an online survey of doctors, nurses, podiatrists and any other person involved in treating patients with diabetic foot ulcers. The study collected information on how they treat patients and if they were interested in taking part in further research.
One hundred and sixty-eight healthcare professionals completed the survey: 111 were surgeons, 48 were podiatrists and 9 were diabetes specialist doctors. There were three scenarios in which tenotomy was offered: to reverse toe deformity, to aid ulcer healing and to prevent recurrence. Tenotomy was often performed by orthopaedic surgeons (76%). The frequency with which tenotomy was performed varied from monthly (48%) to yearly (21%). The method of undertaking tenotomy varied. Some centres perform tenotomy under local anaesthetic (51%) whereas others perform it under a general anaesthetic (6%). Surgical tenotomy was the most preferred method (68%). Prior to tenotomy there was variable assessment of blood supply to the foot and 7% of centres did not assess blood supply at all. Eighty-three responders would like to take part in further research to further investigate tenotomy and other pressure relieving treatments in the diabetic foot.
There is variation in the reason that tenotomy is performed, pre-procedure assessment prior to tenotomy and the way tenotomy is performed. Clinicians responding to this survey are willing to take part in more research in tenotomy. The Vascular Society Specialist Interest Group in the Diabetic Foot will lead further research in this area.