| Goal | Restore blood flow and close the wound to preserve as much of the foot and leg as possible, using revascularization, debridement, and reconstructive techniques. | Remove non-viable or unsalvageable tissue at a level that heals reliably, when the limb cannot be saved or the risks of attempting salvage outweigh the benefits. |
| When it is considered | Preferred first-line approach whenever there is a realistic chance of restoring adequate blood flow and achieving wound healing, guided by the Society for Vascular Surgery's WIfI (Wound, Ischemia, foot Infection) classification. | Considered when infection is life-threatening (e.g. spreading gangrene or sepsis), blood flow cannot be restored despite revascularization attempts, or the patient's overall condition makes prolonged limb-salvage treatment unsafe. |
| Typical process | Multi-step and multidisciplinary: vascular assessment, revascularization (angioplasty or bypass), staged debridement, and wound closure or reconstruction, often over several weeks. | A single surgical procedure (toe, partial-foot, below-knee, or above-knee, depending on the extent of disease), followed by wound healing and, where appropriate, prosthetic fitting and rehabilitation. |
| Hospital stay and recovery | Longer overall treatment course — often 2-4 weeks of inpatient care for revascularization and initial wound management, followed by months of outpatient wound care until full healing. | Shorter initial hospital stay in many cases, with recovery then focused on stump healing, mobility training, and prosthetic rehabilitation where relevant. |
| Evidence on outcomes | Dedicated diabetic foot/limb-salvage units report limb salvage in a substantial majority of appropriately selected patients, but success depends heavily on how advanced the disease is at presentation, how well blood flow can be restored, and diabetes control — it is not guaranteed in every case. | Remains an appropriate and sometimes life-saving option when salvage is not feasible; amputation at the right level, performed promptly when indicated, avoids the risks of prolonged unsuccessful salvage attempts in the face of overwhelming infection or unreconstructable blood flow. |