When would you amputate a limb with diabetic foot ulcer?

When would you start to amputate ulcers for limbs for diabetic foot ulcers? So essentially when the patient asks you to. So we've got a quite a wide spectrum of people that had an amputation so for some of these people they may be young, they may have had a wound that has really failed to respond to antibiotics to offloading to tendon releases to bypasses and they've got a hole in their foot and their whole life is centered around their hospital visits which are pretty much every week they're on antibiotics at home and they've got dressings and they're going nowhere and for those people sometimes it's a welcome relief to have an amputation to get a prosthetic leg and to get on with their life and get back driving get back walking. And, you know, we get the opposite, which might be a patient who has very little time to decide that they need an amputation because they come in very infected, very septic, very unwell. And they may even not have full consciousness sometimes because they can be that ill. And for those patients, it can be a life or death decision. And we have to consult with their relatives. Luckily we have an excellent team when we're considering amputations which can help us make the decision. That includes people like physios who can help us judge the probability of people walking again, things like occupational therapists who can give us an idea of whether people will be able to stay in their own home after their amputation or whether they'll need long-term care, nursing staff and obviously the other members of the team I've talked about and they're all involved in the decision of does patient have an amputation and if so at what level.