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Treating recurrent DFU in patients with a combination of infection, ischemia, and deformities is extremely challenging and this group of patients has a very poor outcome. This case series describes the outcomes of patients with a recurrent DFU and CN, with a mean SINBAD score of 4 and of which 40% had a TCS of D3, using a multidisciplinary protocol that includes reconstructive foot and ankle surgery. In 24\/35 (69%) of patients, wound closure was achieved after a mean of 75\u2009days postoperatively. The mean ulcer\u2010free period was 358\u2009days. The mean number of interventions was 6.7 (range 3\u20139). Post treatment 27\/35 (77%) of patients was mobile, without additional amputation or ulcer recurrence. This study shows that wound closure and a long ulcer\u2010free period can be achieved in patients with a DFU and CN and its multifactorial underlying diseases when treated in a multidisciplinary team, including reconstructive foot and ankle surgery.<\/jats:p>","DOI":"10.1111\/iwj.14045","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T08:32:25Z","timestamp":1672993945000},"page":"1866-1873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Recurrent diabetic foot ulcers: Results of a maximal multidisciplinary approach including reconstructive foot\/ankle surgery"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7139-820X","authenticated-orcid":false,"given":"Wouter","family":"Brekelmans","sequence":"first","affiliation":[{"name":"Alrijne Wound Centre Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Surgery Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbert","family":"van Laar","sequence":"additional","affiliation":[{"name":"Alrijne Wound Centre Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Orthopaedic Surgery Alrijne Ziekenhuis  Leiderdorp The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Tolen","sequence":"additional","affiliation":[{"name":"Alrijne Wound Centre Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Surgery Alrijne Ziekenhuis  Leiderdorp The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rigo","family":"Hoencamp","sequence":"additional","affiliation":[{"name":"Alrijne Wound Centre Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Surgery Alrijne Ziekenhuis  Leiderdorp The Netherlands"},{"name":"Department of Surgery Leiden University Medical Centre  Leiden The Netherlands"},{"name":"Defence Healthcare Organization Ministry of Defence  Utrecht The Netherlands"},{"name":"Department of Surgery, Erasmus MC University Medical Centre Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boudewijn L. 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