A 67-year-old man with Type 2 Diabetes Mellitus presented with a deep plantar diabetic foot ulcer complicated by severe infection, fever, and critical limb ischemia. The combination of systemic infection and poor perfusion created an immediate threat to limb viability, requiring urgent multidisciplinary management.

Endovascular revascularization was performed first to restore adequate blood flow, followed by extensive surgical debridement of all necrotic and infected tissue until healthy, viable margins were achieved while preserving as much functional tissue as possible. Postoperatively, pressure off-loading was achieved using a specialized off-loading walking device to eliminate plantar pressure and promote wound healing.

The infection resolved, the wound healed progressively, and major amputation was avoided. Limb function was successfully preserved through timely revascularization, meticulous surgical debridement, and effective pressure off-loading.

This case demonstrates that successful treatment of ischemic infected plantar ulcers requires a comprehensive limb-salvage strategy. Revascularization, meticulous surgical debridement, and appropriate pressure off-loading are equally essential for achieving durable wound healing and avoiding major amputation.