Diseases

Diabetic Foot

Diabetic foot requires multidisciplinary team effort and expert treatment. Revascularisation and offloading procedures done by a vascular surgeon are one of the mainstay of the treatment along with glycaemic control

An ulcer/ sore is simply a breakage in the continuity and integrity of the skin. It  usually happens due to a small injury or wound on the calf or the foot causing breakage. The skin cannot heal normally i.e. in less than 2 weeks if there is any underlying pathology. Therefore the wound will increase in size and ultimately result in chronic or non-healing ulcer.

Women and the elderly are most commonly affected with conditions like foot ulcers. It may lead to physical disability and if left untreated, may end up in leg loss.

Venous ulcers (due to venous stasis) – Over 70% of all leg ulcers are venous ulcers. Every time you use your calf muscles, blood from the foot reaches the heart via veins. There are one-way valves in these veins to ensure blood goes up from the leg and does not come back. Some people lose these valve’s efficiency due to thrombosis (clots) in the veins. So, blood which is meant to reach the heart returns to the leg and raises veinous pressure resulting in stretching and leaking of fluid into capillaries. Consequently, swelling, skin damage and ulcers develop. This condition is called chronic venous insufficiency.

Arterial or Ischaemic ulcers (due to poor circulation) – Around 10-15% of leg ulcers are Arterial or Ischaemic ulcers. The arteries in the legs are meant to bring oxygenated blood to the foot. In case, arteries get blocked or get narrowed down due to certain reasons like atherosclerosis caused by smoking, high blood pressure, diabetes, high cholesterol, then the circulation in the leg gets compromised. Therefore, the skin becomes vulnerable to ulcers of non healing nature.

Neuropathic or Neurotrophic ulcers (common in diabetics) – Around 15% of all diabetics develop foot ulcers in their lifetime. One’s sole of the foot or the toes may get affected. Diabetes mellitus may risk peripheral occlusive arterial disease and diabetic neuropathy resulting in non-healing ulcerations. Depending upon the underlying cause, foot ulcers in diabetics can be neuropathic, neuro-ischaemic or purely ischaemic (arterial). These ulcers are worsened by smoking, fluctuating blood sugar, malnutrition, poor foot care, etc.

Pressure ulcers: These are caused by continuous long-term pressure on some points on the skin like heel, coccyx, achilles tendon). It usually affects bed-ridden patients or individuals with compromised mobility.

Rare types of ulcers – Around 5% of all leg ulcers occur due to rare causes like angiitis, cryoglobulinemia, some congenital blood disorders, drug induced ulcers, gangrenosum pyoderma, osteomyelitis, skin malignancy etc.

Mixed (or multifactorial) ulcers: These ulcers occur when there are more than one conditions causing damage. For example, if  poor arterial circulation of a leg has venous ulcer, it requires arterial surgery to improve the blood supply.

If you are suffering from any of such conditions, then choose us for the best services as we are delivering the top rated diabetic foot treatment in Telangana.

Some leg ulcers start leaking especially in case of leg swelling. The oozing out Fluids can be foul smelling. This becomes the cause of bacterial infections related to skin or subcutaneous fat. So, antibiotic treatment becomes necessary.

Venous ulcers – The lesions of venous ulcers occur in the medial aspect of the leg especially around the ankle. Venous pressure is maximum in this area and veins.

The leg may be swollen and tender and fibrosis of the skin or subcutaneous tissues may be seen. The surrounding area becomes reddish or brownish, The skin becomes dry and itchy.

Usually, upon getting infected venous ulcers become painful.

Arterial ulcers – It develops in the lower leg or  foot. The affected area is cold and pale  with a red-purple, shiny appearance.

These ulcers are very painful, especially during the night.

Diabetic neuropathy ulcers – The vulnerable areas for these ulcers are legs and feet. These are usually painless. It is one of the prime features of the diabetic foot.

Remember that a leg ulcer is like another wound: it has to heal up in one or two weeks . If this doesn’t take place in your case, see your doctor. Addressing the problem earlier makes the treatment less complicated with better final results. Never watch for a month to seek advice from a specialist! Otherwise, the treatment can become complex and the final results will be less satisfactory. As professionals in treating leg ulcers of vascular disorders, we use diverse techniques.

The mainstay of curing venous ulcer is relieving excessive strain inside the vein with ulcer

Elevation of the leg. Put your legs up each time you can. Elevate your mattress (approximately 15 cm) so that once in bed, your toes/feet are raised higher than your head.

Use compression bandaging or stockings to hold the leg vein pressure at normal. Once the ulcer is healed, compression stockings are typically important to prevent the ulcer from returning.

Wound dressings. Each time you’ve got a wound change, appropriate dressings might be applied. Their preference relies upon the section of wound healing, therefore, dressings might vary from time to time.

Surgery. In a few instances an appropriate operation can be the cure. In the ulcer associated with superficial venous disease, varicose vein surgical treatment is required. Another option is to do grafting at the ulcer. In arterial ulcers, the intention is to ensure sufficient blood flow to the foot. This can be done with arterial bypass surgical treatment (putting a graft) or balloon angioplasty .

Occasionally, antibiotic remedy can be important to control an ulcer, in particular if there are symptoms and symptoms of contamination of the area.

The control of combined ulcers can be more complex.

Choose Hyderabad Vascular Center for the most sophisticated diabetic foot treatment in Telangana.

Chronic venous insufficiency usually takes years to cause the ulcer, so the ulcer may take a longer to heal. Although most of the venous ulcers heal within 3 months.

It is extremely rare that leg amputation occurs due to venous ulcers because even large ulcers can be successfully treated.

An arterial ulcer heals easily, if the procedure is possible to increase blood flow to the foot. In very rare cases, arterial ulcers may lead to leg amputation.

Diabetic individuals with ulcers like neuropathic, neuroischaemic and ischaemic require immediate attention and care.

  • Quit smoking
  • Take healthy diet
  • Exercise aerobically on regular basis
  • Wear surgical stockings as per your physician has recommendations
  • Avoid tight clothing and uncomfortable footwears
  • Have careful check on skin of your legs

It is genuine that ulcers have a tendency to return, in particular in elderly.

In the instances while surgical correction of the underlying disease is feasible, surgical operation normally prevents ulcer recurrence.

If the underlying trouble persists, you need to take proper measures in order that the ulcer doesn’t come back. If you’re recommended to put on compression stockings, you must put on them indefinitely and update them each 3-four months once they lose the efficiency of compression stress that they may be made to exert.

People with diabetes have to cautiously comply with the instructions

Vascular Center works to ensures your best recovery and deliver highest expertise based diabetic foot treatment in Telangana

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