All about Diabetic Foot Ulcer and its treatment
Overview
A diabetic foot ulcer is a complication of diabetes that affects about 15 percent of the global population diagnosed with diabetes. As estimated, 62 million Indians are diabetic. Of this number, approximately 25% go on to develop diabetic foot ulcers. This is by far the most common lower extremity wounds among diabetic patients. The condition accounts for an estimated 85% of the lower extremity amputations. Some of the risk factors that might predispose you to diabetic foot ulcers include uncontrolled hyperglycemia, infection, and poor blood circulation, among others. Some of the defining symptoms of diabetic foot ulcers include drainage in your socks, swelling, and redness on the affected leg. If the condition is not treated, it can emit an odor.
Pain is rarely a symptom of diabetic foot ulcers. This is because, by this time, your pain sensation ability will have diminished. Progression in a diabetic foot ulcer predisposes you to the risk of amputation. To prevent diabetic foot ulcers, it is important that you manage your blood sugar levels within the normal ranges. Additionally, daily foot inspection is important. Timely diagnosis and management of your diabetic foot ulcer also go a long way in reducing the healthcare cost you may end up incurring due to this condition. Additionally, your overall health outcome also improves.
Causes
The main causes of diabetic foot ulcers include:
- High glucose levels: In case your blood sugar levels run high, you are highly predisposed to a diabetic foot ulcer. You will find it increasingly hard to fight infection, especially foot-related ulcers. As such, blood sugar management becomes a vital process for people with type 2 diabetes
- Poor blood circulation: Sometimes, the flow of blood to your feet can be very inefficient as a result of vascular disease. Therefore, ulcers may not heal easily once they have developed
- Damaged nerve: This tends to be a long-term effect but it can also result in diabetic foot ulcers. When this happens, the loss of feeling, especially to your feet, is also lost. Any sensitivity to foot pain is also lost. Consequently, you may end up developing painless wounds that may, ultimately, result in ulcers
- Infection: Once you have diabetes, the conditions tend to weaken your immune system. Therefore, you become highly prone to infections. It is not unusual, therefore, for people with diabetes to develop an infection. Such an infection may take the form of a foot ulcer that does not heal
- Problems with the immune system: Your immune systems play various roles, including getting rid of damaged and dead tissues. Also, the immune system plays a role in the development of new skin cells following an injury or wound. If you are diabetic, your immune system could slow down. What this means, therefore, is that your ability your body’s capability to fight infections in a diabetic foot gets compromised.
Other risk factors include:
- The following factors put you at higher risk for diabetic foot ulcers:
- Poor hygiene: Failure to thoroughly and regularly wash your feet, followed by drying them well
- Poor quality and or fitting shoes
- Being obese
- Smoking, as tobacco use hinders blood circulation
- Certain other chronic conditions, such as kidney disease and heart diseases
Older men are more predisposed to diabetic foot ulcers
Symptoms
If you have a diabetic foot ulcer, you are likely to manifest the following symptoms:
- Redness and swelling especially in your ankle or foot
- Discoloration on the skin
- Sometimes, the wound may emit a foul smell
- The skin temperature may change
- Your feet will develop open sores that are draining and also difficult to heal
- Calluses or corns may develop
- Your skin may develop cracks, and more so the skin around your heels
- Your toenails have a fungal infection
Diagnosis
Your doctor will often diagnose a diabetic foot ulcer during physical examination. He or she is also interested in your medical history. Your doctor would want to find out whether you have such other medical conditions as lower extremity arterial diseases or peripheral neuropathy as these conditions put you at an elevated risk for foot ulcers. Additionally, your doctor would want to know whether there is a history of diabetic foot ulcers in your family as this too is a risk factor.
During the physical examination, your doctor will check for cuts or blisters on your toes and feet. He or she will also check for ingrown toenails and scratches as these can also result in ulcers. Next, the doctor feels the pulse in your foot as a means of determining the flow of blood in your legs.
Your doctor may also request you to stand up and start walking so that he or she can evaluate how your weight has been distributed across the joints and bones of your feet. In case you manifest in a limp, this can be a sign of structural damage. Moreover, a blister could form due to an uneven gait. The shape of your feet is also important, seeing as an abnormal alignment predisposes you to ulcers.
In addition to physical examination, your doctors may also order the following tests:
- X-ray: An X-ray imaging helps your doctors to assess variations in the alignment of the bones in your feet, as this too, can be a risk factor for the diabetic foot ulcer. In case of a loss in bone mass, this too becomes apparent through an X-ray. This can be predisposed by hormonal imbalances associated with diabetes
- Blood test: A blood test will reveal any infections that you might have and that puts you at risk of diabetic foot ulcers. The test is conducted at the doctor’s office. You will get the results after about a week
- MRI scans: An MRI scan utilizes radio waves and a magnetic field to yield high-quality three-dimensional images of your feet. This enables your doctor to determine the extent of damage to your feet as a result of an ulcer. With an MRI scan, your doctor can also tell the extent of inflammation which is, in turn, an indication of infection
Treatment
The main objective of treating diabetic foot ulcers is to manage pain, promote faster recovery and ensuing healing of such wounds. Different patients differ in terms of their overall health and medical conditions. Some patients also have a higher ability to care for wounds than others. Therefore, the treatment plan for diabetic foot ulcers tends to be highly individualized.
To prevent pain due to ulcers, your doctor may recommend off-loading. In other words, you are advised to stay off your feet. Walking results in pressure build-up and if you have an infection, it could get worse. Moreover, the pressure causes an ulcer to expand.
It is important to protect your feet at all times. Your doctor will likely make the following recommendations:
- Wearing of casts
- Wearing shoes that are specifically designed for diabetics
- Compression wraps
- Foot braces are also useful
- Shoe inserts help to prevent calluses and corns
In case of an infected foot ulcer, your doctor is likely to recommend the following:
- Footbaths
- Disinfecting the skin around a diabetic ulcer
- Frequent changes of dressing to keep the ulcer dry
- Calcium alginates dressings to hinder bacterial growth
Medication
In case preventative treatment is not effective in treating diabetic pressure ulcers, your doctor can prescribe certain medications. Some of the medications that are effective in treating diabetic foot ulcers include anti-clotting medication and antibiotics. Also, antiplatelets may be useful. Certain health conditions can predispose you to bacterial infections. These include liver problems and HIV. If you have such a condition, it is important that you mention this to your doctor so that he or she can recommend the most effective medication.
Surgery
In case the preventive procedure and medication fail to treat the condition, your doctor will most probably prescribe surgery. Once your doctor has ascertained that you will need to go through surgery, he or she will refer you to a surgeon. We will give you a discount for any consultation involving a specialist.
Your surgeon will book you for surgery on an appointed date. The surgeon will explain to you the surgical procedure in detail, including the benefits and possible risks. On the day that you are scheduled to undergo surgery, we will make arrangements to have you transported to our healthcare facility in one of the hospital vans.
Some of the surgical procedures include:
Debridement
This is a procedure that allows the doctors to clean out any infected or dead tissues and skin from a foot ulcer. In this way, the doctor gets to evaluate the extent of damage to your soft tissues. Additionally, debridement promotes healing.
Before performing the procedure, the doctor will first administer local anesthesia. He or she will then remove the tissues or skin using a scalpel. This is followed by washing the wound using a disinfectant solution.
Your doctor may have to perform debridement several times within the duration of several weeks or months. This is necessary to promote healing.
Your doctor may also prescribe an ointment to apply on the wound once a day till it heals. Such an ointment helps to destroy dead tissues.
Following debridement, your doctor will use a sterile bandage to cover the wound. You will be advised to keep the wound covered and clean by changing the bandage each day
In case of any discomfort after the procedure, such pain can be managed using over-the-counter medication, at the recommendations of your doctor. Examples of such medication include acetaminophen and ibuprofen.
Achille tendon lengthening
Sometimes, your Achille's tendons put pressure on your bones at the back of your heel and leg, thereby causing ulcers due to the increased pressure. In such a case, your doctor may recommend surgery to correct your gait. The procedure helps to release tension build-up in the tendons, thus leading to improved body alignment and hence pressure released from the ulcer.
The procedure occurs in the hospital or clinic under general anesthesia. During the procedure, your orthopedic surgeon will make a few small incisions in the back of your foot. The goal is to reach your Achilles tendon. Thereafter, the surgeon gently stretches the tendons and cuts them. This results in the lengthened tendon. Your orthopedic surgeon will then apply a splint. The aim of a splint is to make sure your lower leg and foot remain covered. You will need to wear the splint for between two and six weeks.
After removing the cast, you may be required to wear a leg brace for a few more weeks
Post-op care
Once the surgery has been successfully completed, you will be released to go home. We will make arrangements to get you transported back home. While at home, you are encouraged to take as much rest as possible, to promote faster healing. If the surgeon has prescribed any medication, you will need to take it as directed.
Make sure that you change the bandage on your wound each day, and that it remains clean and dry. You are also encouraged to drink plenty of fluids. Ensure your diet contains plenty of vegetables and fruits. If your doctor has recommended any exercises, make sure to do them as directed.
You must also try to control some of the risk factors for a diabetic foot ulcer so that the wound does not become worse. For example, if you are a smoker, quit smoking.
Make sure that your blood pressure, triglyceride, and blood cholesterol levels are within the normal range. You can do this by taking medication based on your doctor’s prescription. You will also need to make dietary changes.
If you are overweight, make sure you reduce it to manageable levels through diet and exercise.
One of the most common complications of diabetes is diabetic foot ulcers, which are nothing but obstinate skin ulcers that do not heal easily. Conventional treatment may not actually help this condition and may cause severe complications.
There are no effective home remedies for this condition. If left untreated, diabetic foot ulcers can cause bone and skin infections leading to pockets of pus called abscesses. These can lead to further complications such as Gangrene.
Low-level laser therapy (LLLT) is a good treatment option for diabetic foot ulcers as it is a non-invasive, pain-free method with very few side effects.
Benefits of Low-level Laser Therapy in Bangalore
- Procedure is non-invasive
- Minor side effects
- No pain during or after the procedure
- Cost-effective
- Accelerates healing of the wound
- Better control of infection
How can goficure help with the treatment of diabetic foot ulcers for patients in Bangalore?
Goficure has collaborated with a leading team of dialectologists and specialists in Bangalore to offer the best care for diabetic foot ulcers. A patient already suffering the condition may find it extremely challenging in a place like Bangalore to find specialist care at optimum costs.
What we offer you is complete solutions to your health problems under one roof. Our service to you in a nutshell:
- Connecting you with the right specialist
- Enabling a diagnosis
- Scheduling the procedure
- Supporting the patient all through the procedure
- Post-operative care
- Diet chart and recovery plan during post-op phase
- Support till complete recovery from the problem
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
Guarantees
Smooth and hassle-free
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Why Goficure?
Specialist doctors
Our doctors are vetted for their experience and skills. Rest assured, you are in safe hands. The best treatment for your condition is delivered all the time
Medi-Pal assistance
A dedicated Medi-Pal is assigned to take care of the entire process. This includes booking your appointments, scheduling the surgery, handling your documentation including claiming insurance, discharge, and post-op recovery
Affordability
Goficure delivers high-quality treatment to you at affordable prices. Superior treatment and best quality of service is assured while keeping costs reasonable
Post procedure care and follow-ups
Our engagement doesn't end after your surgery. It continue until you go back to your normal life. Free diet and exercise consultations during your recovery phase are offered to ensure a quick recovery
Comparison
With so many options, are you wondering what the right choice for your condition is? While you can opt for either an open surgery or a laser surgery, numerous studies have shown that laser surgeries are far more effective. Be it the duration of the procedure, post-operative pain or recovery time, laser surgeries always outrank open surgeries and are therefore, a better choice. Here is a quick comparison that will help you decide your course of action.
What you don’t undergo with goficure
1. Long waiting lines
2. Lack of personalized attention
3. Excessive billing/hidden charges
4. Running around for your treatment
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