Diabetic Foot & Wound Management



We are wound specialist

Wound is breach in epithelium. Normally any wound heals on its own within a span of 3 months.

Diabetic wounds

Foot infections – among the most frequent and serious consequences of diabetes mellitus Responsible for more hospital days than any other complication of diabetes Dealing with this problem will require both, a greater understanding of the pathophysiology of these infections and better systems for implementing proven effective measures International Consensus on Diagnosing and Treating the Infected Diabetic Foot (2003) Any infection involving the foot in a person with diabetes originating in a chronic or acute injury to the soft tissues of the foot, with evidence of pre-existing neuropathy and/or ischemia 250 million diabetics by 2025 2-5% of diabetics develop foot ulcer annually Point prevalence of ulceration estimated at 4-10% 40-60% of all non-traumatic lower extremity amputations are in diabetics 85% of these preceded by foot ulcer

First time presentation of Diabetic foot

Male Type 2 diabetes
Average age – 56 yrs
Average duration of diabetes – 12 yrs
Most have some degree of Neuropathy
Few have Peripheral Vascular Disease
Common precipitating factors
Lack of footwear
Irregular foot care
Burns After 1st episode of Surgical Rx
Male (M:F – 227:147)
Mean age – 55 yrs (54.9 +/- 9.4 years)
Diabetes duration – 11 (10.9 +/- 7.7 years)
Majority of the patients had grade II and III ulcers (50% and 26.5%, respectively)
Grade IV was seen in another 21.9%
The median healing time was 44 days
Recurrence of infection occurred in 53%
More common in patients with neuropathy and peripheral vascular disease (PVD)

Cost Burden

Diabetic subjects with foot problems incur very heavy expenditure in the treatment process Most of the direct costs of diabetes treatment result from its complications The hospitalization costs for the complications of diabetes are particularly heavy Total median expenditure Without foot complications (n=164) – Rs. 4,373 With foot omplications (n=106) – Rs. 15,450

Etiopathogenesis of diabetic foot

Multi-factorial, Complex and still poorly understood Neuropathy Vasculopathy Immune dysfunction Infection
Prolonged Hyperglycemia contributes to all the above factors through different mechanisms
Infection

A major factor in the pathway leading to amputation a contributor to soft tissue loss A reason for delayed wound healing

Patient presents with

  • Redness and swelling of a foot that even when neuropathic causes some discomfort and pain; this often indicates a developing abscess, and urgent surgery may be needed to save the leg
  • Cellulitis, discoloration, and crepitus (gas in soft tissues)
  • Pink, painful, pulseless foot even without gangrene indicates critical ischaemia that needs urgent arterial investigation followed by surgical intervention whenever possible
  • Treatment of diabetic foot mainly includes
  • Debridement
  • Amputation
  • Vascular reconstruction
  • Flap reconstruction

Medical Excellence

Over 10 Years of

EXPERIENCE

Dedicated & Pro

TREATMENT

Tendulkar2

Rajendra Nursing Home, A-001, Yogi Guru Kripa HSG, Yoginagar, Eksar Road, Near Aura Hotel,
Borivali West, Mumbai- 400091

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