Diabetic foot Wound care / debridement

Wound care in diabetic foot :
Attention to the minor details of the foot care can avoid the major complications. Careful paring of the nails, skin care, callus excision (by professionals), moisturizing cream application are known to avoid the major complications. In one of the recent meetings conducted at NIMS ( by vascular surgery, Diabetes departments) the importance of team work and foot care has been explained to doctors who came neighboring districts and states. Practical demonstration of the Excision of the calluses using oranges and sharp blade. The orange peel is comparable to the the plantar skin of foot. Neuropathic ulcers with excessive callus around them heal much faster and safely after adequate removal of the thickened skin (Callus) around the wounds.
( Photograph: Participating team of doctors who are providing care to the diabetic foot patients in NIMS)

Pinjala R K

Diabetic Foot

The feet in Diabetic persons need special attention to avoid the trauma, infection, ulceration, gangrene and amputation. The protective sensations in the foot are diminished due to peripheral neuropathy ( Nerve damage). At the same time the circulation to the foot is also diminished due to thickening and calcification of the arterial walls in the leg. That means diminished sensations (pumbness)results in frequent trauma which is often neglected (due to lack of pain)the resulting wounds fail to heal due to the diminished blood supply. The end result is wound which gets infected by multiple organisms. These infections are initially easily controlled but later the resistant organisms start colonizing the wounds. They spread proximally and produce infective gangrene which forces us to consider an amputation. In 80% of the diabetic patients who are loosing the legs there is a history of trauma as precipitating factor and could have been avoided by simple protective and preventive measures. So, protection feet and prevention of injury is the primary responsibility of the people to avoid the complications of diabetic foot which can lead to disability even after excellent treatments.

by
Pinjala R K