Diabetic foot is a very common disease in Europe and America. In recent years, with the improvement of the living standard of our people, the incidence of diabetes has gradually increased, and the lack of knowledge of diabetes among people living in underdeveloped areas has led to a gradual increase in the incidence of diabetic foot, and the incidence of young and middle-aged people has gradually approached that of Europe and America. Paying attention to the early treatment of diabetes is the key to prevent the disease. However, along with the aging process in China, more and more elderly people inevitably still have limb lesions in the distal extremities after a 10- or even 20-year course of the disease. Adjustment of blood sugar is the specialty of endocrinology. Our specialty in orthopedics and plastic surgery is the management of the diabetic foot. “Diabetic patients with peripheral neuropathy and peripheral vascular disease combined with excessive mechanical stress can cause destruction and deformity formation in the soft tissues of the foot and the osteoarticular system, which in turn can lead to a range of foot problems, from mild neurological symptoms to severe ulcers, infections, vascular disease, Charcot arthropathy and neuropathic fractures. ” To put it plainly, the late development of diabetes is mainly damage to peripheral nerves and blood vessels. The ends of our limbs concentrate the most small nerves and blood vessels in the body (nerves are for sensation and innervate muscle and tendon activities, and blood vessels are for providing nutrition to tissues), and once these small nerves and blood vessels have problems, it directly affects the sensation, movement and nutrition of the hands and feet. Problems with sensation are more frightening, and the direct problem of no sensation and no pain is the lack of protective mechanisms for the foot. Pressure or shear forces from the ground, shoes, or other adjacent toes cause ulcers to form, which are often aggravated by the presence of bony prominences due to the lack of normal neuroprotective mechanisms. Damage to the autonomic nerve interferes with normal perspiration function, the thermoregulation of the skin, resulting in reduced plantar flexibility and more prone to skin breakdown. Damage to the blood vessels results in a poor nutritional status of the end, making it difficult to heal once a rupture has occurred. Repeated infections may complicate bone infections, which is what we described earlier as osteomyelitis. The diagnosis of diabetic foot is relatively simple, history of diabetes + foot breakdown, ulcer formation, and if the history is long, there may be approach to foot deformity. We also often encounter patients who are unaware of their diabetes due to lack of physical examination or in the early stages of diabetes. These patients also have some lower extremity sensory abnormalities, such as peripheral vascular neuropathy or disc herniation, and come to the clinic only after trauma or foot abrasion, when the wound repeatedly does not heal. There are also some gout patients who have been treated mainly for gout without paying attention to blood sugar, often with very heavy symptoms and treatment in the wrong direction, resulting in poor results. We once again call on middle-aged and elderly patients to, first, regularly review their blood glucose and, second, pay sufficient attention to lumbar spine or extremity vascular neuropathy. Patients who cannot be cured by changing medication with good blood sugar control, or patients with recurrent recurrence, are in need of surgical treatment. Surgical treatment is divided into limb preservation surgery and amputation surgery. This is what we call individualized treatment in medicine. A specific treatment plan needs to be made according to the patient’s disease condition. Before surgery, blood sugar control is especially critical, and the patient’s serum albumin and hemoglobin need to be replenished to normal. Ultrasound or CT angiography should also be performed to evaluate the blood vessels of the lower extremities. However, for patients with poor neurovascular conditions, limb preservation therapy is not suitable, and forced limb preservation will only bring more burden to them, and the final result will be amputation, and the wound will not heal. In this regard, we as clinicians should also educate patients about the disease before surgery, so that they can fully recognize the severity of the disease and correctly choose the most suitable treatment. At the same time, for which patients can be treated with limb preservation, our department infection group has unique insights after years of accumulated experience and has successfully saved many cases of affected limbs.