Diabetic Foot Problem
The people, who have diagnosed with diabetes more likely to suffer from the Diabetic foot problems. The diabetic foot problem is resulted due to combined actions of hyperglycemia on the vascular, nervous, and immune systems which can be projected into subsequent abnormalities of a musculoskeletal architecture of the foot. If it is not treated for a longer period then it can further lead to serious complications such as a major or minor amputation.
Diabetic Foot Ulcers
It is an ulcer or wound usually occurs in a diabetic person and located on the dorsum or bottom of the foot.
The increase in age and the duration of diabetes can increase the complications of diabetic foot ulceration and limb amputation.
Also, there is good news that a diabetic foot ulcer can be preventable if its underlying causes such as peripheral neuropathy or peripheral arterial disease are appropriately diagnosed and treated.
Signs and symptoms:
- Ulcer drainage reveals on the socks of a footwear
- Swelling and Redness in the area
- Bad odor if ulcer has progressed significantly
Primary causes of diabetic foot ulcers are
- Peripheral neuropathy which involves nerve damage
- Peripheral artery disease which involves lower extremity ischemia or lack of blood flow
- Peripheral Neuropathy:It is the leading cause of diabetic foot ulcers that leads to nerves damage including the motor, sensory and autonomic nerves. Patients are no longer able to feel pain, heat or cold in their feet and on wearing poorly-fitted shoes may cause ulcers or blisters. If these ulcers are not treated immediately then infection may further spread on the bone to cause serious complication that might need surgery.
- Peripheral Artery Disease (PAD): Diabetes may leads to complications of PAD including damage to blood vessels, narrowing or hardening of the arteries. A narrow passage down the arteries of feet may cause ischemia due to poor blood circulation and leads to a slow or hampered healing of foot ulcers.
Other diabetic foot problems are
- Athlete’s foot: Athlete’s foot is a fungus infection of the skin of foot or toenails that causes itching, redness, and cracking. This need to be treated well before it poses a risk of serious complications.
- Fungal infection of Nails: The dark, moist, and warm footwear environment can give rise to fungal growth on nails to make it discolored, yellowish-brown or opaque and in many cases, nails may crumble also.
- Corns: Corns are the development of hard skin between toes or near a bony area of a toe that may be caused due to pressure from shoes that continuously rub against the toes and creates friction between the toes.
- Treatment: A diabetic wound/ulcer may lead to serious complications like cellulitis, infected foot ulcers and osteomyelitis. Moreover, these complications are riskier in patients with impaired immunity. The aim of treatment resides in accelerating the healing process, reducing the chances of infection and/or preventing recurrence of infection. Recently, stem cell treatment in diabetic foot is a completely new and extremely effective way of intervention that not only helps to relieve the symptoms but also control them to build stamina to fight the very core of the problem.
- Diabetic Foot Surgery:A Diabetic foot surgery is generally performed at an early stage to correct deformities, relieve pressure areas and reduce the risk of developing an infection. The basic goal to treat Diabetic Foot Surgery is to speed up the healing process, minimize the chance for infection, and avoid recurrence of infection to prevent amputation. Before performing a surgery a vascular surgeon and/or podiatric surgeon evaluate a diabetic foot infection so as to determine the need for debridement, revisional surgery on bony architecture, vascular reconstruction, or soft tissue coverage.
A step-wise treatment process includes:
- Optimum glucose control
- Surgical Debridement to remove all thickened or all hyperkeratotic skin, infected tissues including necrotic or dead tissues etc.
- Systemic antibiotic therapy to treat deep-seated infections, drainage, and cellulitis
- Off-loading: Relieving any pressure from the affected area using a special foot gear, specialized castings, a brace, a wheelchair or crutches.
- Allowing a moist wound environment
- Cellular therapy or growth factors treatment for unhealed wound
- Always keep wounds and ulcers covered and moist using topical medications and dressing for faster healing.
- Ulcer dressings, growth factors, saline products and skin substitutes can be highly effective in foot ulcers healing.
- Make sure ulcerated/wound area has adequate circulation
- Continuous blood glucose control is critical for an effective healing process and minimizing major complications.
- Recently, stem cell treatment in diabetic foot is a completely new and extremely effective way of intervention that not only helps to relieve the symptoms but also control them to build stamina to fight the very core of the problem.
- Inspect feet daily for bruises, cuts, cracks, blisters, redness, ulcers, or other signs & symptoms.
- Avoid Smoking
- Reduce alcohol consumption
- Reduce high blood cholesterol
- Control blood glucose levels
- Wear proper fitting shoes and socks
Skin grafting of diabetic foot patients
Time for healing
Healing time may vary from few weeks to several months, depending on:
- Wound location & size
- walking or standing pressure on the wound
- Degree of swelling
- Circulation issues
- Level of blood glucose
- Treatment methods applied for wound healing
- Risk Reduction