Multi-disciplinary limb salvage · UK
Diabetic foot surgery, MDT limb salvage and reconstruction.
A vascular surgeon, an orthopaedic or podiatric surgeon, a diabetes physician, a podiatrist and a tissue viability nurse — planning your foot together, from urgent debridement to reconstructive offloading, amputation and lifelong footcare.
Why patients choose us
- 01
A true multi-disciplinary team
Vascular surgeon, orthopaedic or podiatric surgeon, diabetes physician, podiatrist, microbiologist, orthotist and tissue viability nurse — decisions made together, not in silos.
- 02
Limb salvage before amputation
Where the foot can be saved, we plan revascularisation, targeted debridement and offloading first. Where it cannot, we say so honestly.
- 03
Lifelong footcare after surgery
Surgery is one moment in a long relationship. Custom orthotics, protective footwear and lifelong podiatry are set up before you leave.
Indicative pricing
What diabetic foot surgery costs privately in the UK.
Indicative ranges across our MDT partners. Every case is quoted individually after the vascular and microbiological workup.
In short
A full diabetic foot workup and MDT plan: £1,500–£3,500 — before any surgery is booked.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Diabetic foot MDT consultation | £350–£600 | 60 min | Same visit |
| Vascular workup (ABI, TBI, TcPO₂, duplex) | £450–£900 | 60–90 min | 3–5 days |
| CT or MR angiogram | £650–£1,200 | 30–60 min | 2–3 days |
| Debridement and bone biopsy | £1,800–£3,500 | 45–60 min | Same visit |
| Achilles tendon lengthening or tenotomy | £3,500–£6,500 | 30–60 min | Day case |
| External fixation for Charcot foot | £12,000–£25,000 | 2–3 hours | Inpatient stay |
| Digital, ray or transmetatarsal amputation | £6,500–£14,000 | 60–90 min | Inpatient stay |
| Below- or above-knee amputation | £15,000–£30,000 | 90–120 min | Inpatient stay |
Prices vary by hospital, complexity, inpatient length of stay, revascularisation performed and prosthetic requirements. Firm quotes follow the MDT decision.
The problem
One team, one plan, one foot.
Diabetic feet fail when specialists work in sequence rather than together. We put vascular, orthopaedic, medical and podiatry decisions on one table, in one room.
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Ulcer that will not heal?
Deep bone biopsy, vascular imaging and a proper offloading plan — before another dressing change.
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Hot, swollen foot with diabetes?
Assume Charcot until proven otherwise. Immediate offloading and MRI, not oral antibiotics and wait-and-see.
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Told you need amputation?
A second opinion from a true limb-salvage MDT — many amputations become reconstructions with the right vascular input.
The journey
From workup to lifelong podiatry — in the right order.
One coordinator holds the plan from first message to the high-risk foot clinic that keeps you out of hospital.
Phase 1 · Before surgery
Workup and MDT decision
Phase 2 · Surgery
In theatre
Phase 3 · After
Offloading and lifelong footcare
- 01
Before
Vascular and microbiological workup
ABI, toe pressures, transcutaneous oxygen and angiography define the blood supply. Deep bone biopsy and cultures identify the true organism, not the swab contaminant.
- 02
Before
Medical optimisation
HbA1c, nutrition, cardiac risk and anticoagulation reviewed. Angioplasty or bypass is planned first if the foot is ischaemic — surgery on an unrevascularised foot will not heal.
- 03
Before
MDT decision
The diabetic foot MDT agrees the plan — debridement, reconstruction, minor amputation or major amputation — and the level that gives the best functional outcome.
- 04
Surgery
Surgery
From bedside debridement to external fixation of a Charcot foot or a formal amputation in theatre. Bone samples sent for extended culture and histology.
- 05
After
Offloading and antibiotics
Total contact cast or removable boot, strict non-weight-bearing where indicated, and 4 to 6 weeks of targeted IV antibiotics if osteomyelitis was confirmed.
- 06
After
Rehab and orthotic prescription
Physiotherapy, gait retraining and prosthetic fitting where relevant. Custom insoles and bespoke footwear made to protect the reconstructed or amputated foot.
- 07
After
Lifelong podiatry
Structured follow-up in a high-risk foot clinic — the single intervention that most reduces re-ulceration and contralateral limb loss.
Typical workup: 1–3 weeks. Healing after minor amputation: 8–12 weeks in cast. Prosthesis after BKA: 6–12 weeks.
When it helps
When diabetic foot surgery is the right step.
The situations that reach the MDT — plus the ones that need an emergency department, not an outpatient appointment.
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Acute Charcot foot
A hot, swollen, deformed foot with intact skin — the window for external fixation to prevent collapse is short.
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Non-healing neuropathic ulcer
An ulcer sitting over a bony prominence that will not heal without correcting the underlying deformity.
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Osteomyelitis
Bone infection confirmed on MRI and biopsy — debridement plus 4 to 6 weeks of targeted IV antibiotics.
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Wet gangrene or spreading sepsis
A limb-threatening emergency needing urgent guillotine amputation and stabilisation before formal reconstruction.
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Failed prior foot surgery
Recurrent ulceration, transfer lesions or breakdown after a previous amputation — revision to a more stable level.
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Ischaemic foot before surgery
Rest pain, tissue loss or non-palpable pulses — angioplasty or bypass must come first for wounds to heal.
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Hammer toes and forefoot deformity
Tenotomy, Keller’s procedure or first MTP arthroplasty to unload pressure points before ulceration recurs.
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Red flag: hot, red, swollen foot
In diabetes, this is Charcot until proven otherwise — never assume simple cellulitis. Immediate offloading and imaging.
Procedure options
The spectrum, from debridement to major amputation.
Every option that the MDT weighs — the least destructive procedure that still solves the problem is the one we choose.
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Sharp debridement
Removal of necrotic tissue and callus at the bedside or in theatre — the foundation of every diabetic foot plan.
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Exostectomy
Shaving down a bony prominence beneath a chronic ulcer to allow it to close and stay closed.
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Achilles tendon lengthening
A percutaneous procedure that offloads the forefoot in equinus deformity — reduces plantar ulcer recurrence.
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Gastrocnemius recession
An alternative to Achilles lengthening that preserves more push-off strength while relieving forefoot pressure.
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Tenotomy of hammer toes
A minimal-incision release of a flexed toe to heal an apical ulcer.
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Keller’s procedure / first MTP arthroplasty
Resection or replacement of the first metatarsophalangeal joint for a chronic hallux ulcer.
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External fixation for Charcot
A circular frame stabilises the midfoot or hindfoot while collapse consolidates — often combined with arthrodesis.
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Digital or ray amputation
Removal of a single toe, or a toe with its metatarsal — the least destructive option when the forefoot is salvageable.
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Transmetatarsal amputation
Amputation across the metatarsals preserving a functional weight-bearing foot in a shoe with insole.
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Chopart or Syme amputation
Midtarsal or ankle-level amputation when the forefoot cannot be saved but a below-knee amputation can be avoided.
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Below-knee (BKA) amputation
When the foot is not salvageable — a well-fashioned BKA with prosthesis gives the best functional outcome in most patients.
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Above-knee (AKA) amputation
Reserved for extensive necrosis, unreconstructable ischaemia or a non-viable BKA stump.
Our vetted UK network
A short list of true limb-salvage MDTs, we picked them.
A handful of centres in the UK where vascular, orthopaedic, podiatric and medical teams genuinely sit in the same room for every case.
Selection criteria
How we choose every diabetic foot centre in our network.
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True diabetic foot MDT — vascular and orthopaedic or podiatric surgery on the same list
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Interventional radiology and vascular bypass available for revascularisation
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Deep tissue and bone sampling — not swabs — to guide antibiotic choice
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In-house orthotist, prosthetist and high-risk foot clinic for lifelong follow-up
Red flags and safety
The signs that turn an appointment into an emergency.
Diabetic feet deteriorate faster than most patients or clinicians expect. Knowing what is a red flag — and acting on it — is the difference between a toe and a limb.
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Limb-threatening ischaemia is an emergency
A cold, pulseless, painful foot needs same-day vascular assessment — hours matter for salvage.
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Wet gangrene needs urgent amputation
Spreading, foul-smelling necrosis with systemic signs — a guillotine amputation controls sepsis before formal closure.
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Sepsis and SIRS from a foot infection
Fever, tachycardia, confusion or lactic acidosis in a diabetic with a foot wound is a surgical emergency — resuscitation and theatre together.
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Osteomyelitis needs long IV antibiotics
Confirmed bone infection typically needs 4 to 6 weeks of targeted intravenous antibiotics after surgical debridement.
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Charcot foot mimics cellulitis
A hot, swollen, red diabetic foot with intact skin is Charcot until proven otherwise — antibiotics alone will not fix it, and weight-bearing accelerates collapse.
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Contralateral limb is now at risk
After any diabetic foot surgery the other foot inherits extra load — daily inspection and podiatry review are non-negotiable.
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Non-healing after surgery
Wounds that fail to progress at four weeks need re-assessment of blood supply, infection and offloading — not just more dressings.
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Stump breakdown and prosthesis intolerance
A common late complication — early prosthetist review and revision surgery where needed protect mobility.
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The psychological weight is real
Amputation is a bereavement as well as an operation. Structured psychological support is part of the pathway, not an optional extra.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the surgery was a bedside debridement or a major amputation, the note keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your MDT review, just ask.
- 01 Header
Indication and level of surgery
Why the procedure was done — osteomyelitis, ischaemia, Charcot, non-healing ulcer — and the anatomical level chosen by the MDT.
- 02 Technique
Vascular status and operative detail
Pre-operative blood supply, revascularisation performed, surgical technique, tissue sent for microbiology and histology.
- 03 Findings
Bone and soft tissue findings
Depth of infection, margins reached, viability of tissue, and whether all infected bone was cleared.
- 04 Impression
Offloading, antibiotics and follow-up
Read this first: your cast or boot, weight-bearing status, antibiotic plan, and the high-risk foot clinic appointment.
Recognised by major UK insurers
Diabetic foot surgery is almost always funded by insurers when medically indicated, though pre-authorisation is essential given the length of stay and prosthetic costs. We confirm cover before booking.
Frequently asked
Everything we get asked about diabetic foot surgery.
Straight answers on MDT decision-making, vascular workup, amputation levels and what happens after.
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What is diabetic foot surgery?
An umbrella term covering everything from bedside debridement of a diabetic foot ulcer, through reconstructive offloading procedures such as Achilles tendon lengthening or exostectomy, external fixation for Charcot foot, minor amputations (toe, ray, transmetatarsal) and major amputations (Chopart, Syme, below- or above-knee). It is always planned by a multi-disciplinary team.
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Why does a diabetic foot need an MDT?
Because no single specialist can manage it well. Vascular surgeons restore blood supply, orthopaedic or podiatric surgeons reconstruct the foot, diabetes physicians optimise glycaemia and nutrition, microbiologists guide antibiotics, podiatrists and orthotists deliver offloading, and tissue viability nurses manage wounds. Decisions made in one room outperform decisions made in sequence.
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Do I need vascular tests before surgery?
Yes. Ankle-brachial index, toe pressures, transcutaneous oxygen and imaging (duplex, CT or MR angiography) define whether the foot has enough blood supply to heal a wound. Operating on an ischaemic foot without first restoring flow is the single commonest reason surgery fails.
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Can amputation be avoided?
Often, yes — with prompt revascularisation, targeted debridement, offloading and reconstructive procedures such as Achilles lengthening or exostectomy. But when the tissue is not viable, or sepsis is uncontrolled, a well-planned amputation at the right level restores mobility faster than a doomed salvage attempt.
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How long is recovery after diabetic foot surgery?
Debridement heals over weeks; a transmetatarsal amputation typically 8 to 12 weeks in a total contact cast; a Charcot reconstruction with external fixation 3 to 6 months in frame; a BKA around 6 to 12 weeks to prosthesis fitting. Full functional recovery takes considerably longer and depends on rehabilitation.
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What happens after surgery — for the rest of my life?
Custom insoles or bespoke footwear, structured podiatry in a high-risk foot clinic, daily foot inspection, and rapid access back to the MDT for any new wound. This is the single most important part of the pathway — surgery buys time; footcare keeps it.
Related guides
Looking for something else?
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Diabetic foot
Neuropathy, ulceration and the daily footcare that prevents surgery.
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Type 2 diabetes
The underlying condition — diagnosis, treatment and complication prevention.
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Diabetes treatments
Medical and surgical options across the diabetes pathway.
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All tests
Every test and procedure we arrange.
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