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Diabetic Foot Ulcer Treatment
Treatment of diabetic foot ulcers: Diagnosis, Procedure, and Recovery
In cases where ulcers on your foot do not heal, it may be a sign that you have diabetes. Consult our vascular surgeons at Krescent Healthcare for safe and advanced diabetic foot ulcer treatment. Our vascular doctors provide patients with customised treatment based on their individual needs. Contact us today to schedule a consultation.
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What is Diabetic Foot Ulcer?
A wound that forms in the feet and progresses into an ulcer is a common complication of diabetes, caused by inadequate blood flow and nerve function. Individuals with diabetes are at risk of developing ulcers from even minor injuries due to peripheral neuropathy (lack of nerve sensation in the feet) and damage to blood vessels. As a result, patients may not experience pain or discomfort in their legs from cuts, blisters, or sores, leading to slow or non-healing wounds.
When left untreated for a significant period, minor injuries can lead to the formation of ulcers that can spread to the deeper tissues and bones. Inadequate management of diabetic foot ulcers puts patients at a high risk of infection, potentially causing tissue death and even requiring amputation. Therefore, proper management and treatment of foot ulcers are crucial for the patient's well-being. At Krescent Healthcare, we offer a personalised approach to create a tailored plan for each patient's needs to promote healing and alleviate symptoms. For more information on this condition and its treatment options, please contact us.
Diagnosis
It is important to conduct thorough exams and evaluate the extent of the wound and the overall health of the patient before beginning treatment for diabetic foot ulcers.
MRI or CT Scan: An MRI or CT scan may be performed if a doctor suspects deeper tissues may be involved in the ulcer or that infection from the wound has reached the bone.
Clinical Assessment: In this assessment, the doctor evaluates the size, depth, and appearance of the foot ulcer. He also checks for infection and inflammation.
X-rays: Using this test, you can determine whether there are any underlying bone issues, such as osteomyelitis (bone infection) or fractures.
Blood Tests: During a complete blood count, the patient's blood sugar levels (HbA1c), kidney function, and white blood cell count (indicating infection) are assessed.
Biopsy: It may be necessary to biopsy the wound or ulcer to check for malignancies.
Monofilament Test: It involves using a thin nylon filament, which is applied to the foot to measure the ability to sense pressure. As neuropathy increases, the risk of foot ulcers increases.
Doppler Ultrasound: Blood flow in the arteries and veins of the affected foot is assessed, which identifies blockages and reductions.
Ankle-Brachial Index (ABI): Comparing ankle and arm blood pressure is a simple, non-invasive way to determine peripheral artery disease (PAD), which can affect wound healing.
Vascular Studies: In order to evaluate the blockages in the blood vessels with greater precision, advanced tests such as angiography or magnetic resonance angiography can be used.
Surgery and Types
When conservative treatments fail to promote healing of diabetic foot ulcers or complications arise, such as severe infection, extensive tissue damage, or bone involvement, surgery may be necessary. A surgical intervention is designed to remove dead or infected tissue, improve blood flow, and speed up wound healing.
Types of Diabetic Foot Ulcer Surgery
The following are some common surgical approaches for treating diabetic foot ulcers:
Amputation: Amputation of the affected toe, foot, or leg may be necessary if the ulcer is extensive, severe infection exists, or blood flow cannot be restored.
Debridement Surgery: In order to facilitate healing, it removes hyperkeratotic tissue, fibrin, biofilm, and necrotic tissue from the ulcer wound. By using this technique, the small vessels that transport fresh blood to the edges of the debrided wound can initiate the wound-healing process.
Joint Fusion or Removal: Joint fusion (arthrodesis) or joint removal (joint disarticulation) may be considered if an infected joint is contributing to the ulcer.
Flap Surgery: In this approach, a section of healthy skin and its underlying blood vessels are transferred from one area of the body to the wound site.
Osteomyelitis Surgery: In cases of bone infection, surgery may be performed to remove the infected bone tissues.
Revascularization or Vascular Reconstruction/Restoration: Angioplasty or bypass surgery are used in this surgical approach. An angioplasty involves placing a stent or balloon catheter to open up blocked or narrowed blood vessels. In cases of blocked arteries, a vascular bypass surgery can be performed to restore blood flow to the wound.
Surgical interventions are often part of a comprehensive treatment plan that includes managing diabetes, optimising wound care, and addressing contributing factors. After discussing the treatment options with the patient and the specialist, the patient usually decides to undergo diabetic foot ulcer surgery.
Benefits of Treatment
Diabetic foot ulcer treatment offers several benefits in terms of improving the foot and overall health of patients. The key benefits include:
Increased Mobility: The patient can move and walk freely without pain and discomfort associated with open wounds by treating foot ulcers.
Prevention of Infection: Due to compromised immune responses and reduced blood flow, diabetic foot ulcers are prone to infection. Treatment helps prevent or control infections, which can be life-threatening.
Pain Relief: Foot ulcers in patients with partial neuropathy cause severe pain, which is relieved by treatment.
Psychological Well-being: It is well known that injuries, especially severe ones like foot ulcers, can have a negative effect on an individual's mental health and well-being. Treatment can provide relief from the stress and anxiety associated with chronic ulcers.
Prevention of Recurrence: As the patient learns that he/she is prone to developing foot ulcers as a result of inadequate diabetes management, they become more aware and educated on how to prevent recurring ulcers.
Reduced Risk of Amputation: In order to reduce the risk of amputation, it is important to treat foot ulcers early and appropriately.
Recovery After Treatment
Based on the severity of the ulcer and the treatment approach, diabetic foot ulcer recovery varies. It is estimated that recovery will last between one and three months, but can last even longer if further intervention is required. Here is a general timeline for recovery:
1. The wound must be closely monitored after treatment for signs of infection or delayed healing. In order to maintain a clean and healing environment, dressings may need to be changed on a regular basis. After 1 to 2 weeks, there will be significant swelling, redness, and bruising in the treated area.
2. Following the healing of the ulcer, any discomfort or pain associated with it should gradually subside. The patient will require a follow-up to monitor the healing process and adjust medication if necessary.
3. If offloading devices were used to prevent pressure on the wound, patients may need to continue using them until the wound is fully healed.
4. Physical therapy or rehabilitation exercises may be recommended to restore strength and mobility in the affected foot, depending on the treatment approach.
Recovery timelines can vary based on individual factors, so some patients may recover more quickly than others.
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