Diabetic foot deformity correction
Dr Rajendra S Gujjalanavar conducts a special clinic for diabetic foot care
The diabetic foot syndrome or disease (DFD) includes several pathologies, mainly diabetic peripheral neuropathy, peripheral arterial disease and limited joint mobility which result in foot ulceration. Diabetic foot ulceration may ultimately cause amputation, especially when wound infection or osteomyelitis are involved.
Treatment requires multi-disciplinary management with involvement of plastic surgeon, podiatrist, endocrinologist and physiotherapist etc.
Dr Rajendra S Gujjalanavar conducts a special clinic for diabetic foot care this include foot examination and foot care, nervous system examination, examination by endocrinologist, ophthalmologist and podiatrist.
Management of ulcers and preventing their recurrence is vital for the standard of life of the individual and reducing the cost of care of treatment.
Altered bio-mechanics as a result of deformities secondary to neuropathy and limited joint mobility results in focal points of increased pressure, which compromises circulation resulting in ulcers.
Ulcer management should include correction of altered biomechanics to reduce the focal pressure points and prevent recurrence along with measures to heal the ulcer.
Patients with diabetic foot problems are divided into four classes of incremental severity.
- Class 1 – the foot at risk.
- Class 2 – superficial ulcers without infection.
- Class 3 – the crippled foot.
- Class 4 – the critical foot treatment is based on this.
Class 1 foot are often managed conservatively with foot care and appropriate foot wear.
Class 2 in addition to measures for ulcer healing would need surgery to correct the altered bio mechanics to prevent the recurrence ( preventive surgery). The procedures called surgical offloading would depend upon the location of the ulcer and requires thorough clinical study of the foot.
Class 3 would need major reconstructive procedures (skin graft, flap cover (local/free flap)
Class 4 would need amputation since it may be life threatening
Also diabetic foot patients need Nerve surgeries to relieve from nerve compression symptoms (tarsal tunnel release and common peroneal release) and vascular surgeries to improve blood supply (angioplasty & stenting/ open bypass surgery).
Foot Care in diabetic mellitus
Foot care is an important part in diabetic patients. Diabetes may cause you to possess problems due to poor blood flow (circulation) to your feet and legs, which may cause your skin to:
- Become thinner and drier.
- Break more easily.
- Heal more slowly.
- Peel and crack.
You may even have nerve damage (neuropathy) in your legs and feet, causing decreased feeling in them. This means that you simply might not notice minor injuries to your feet that would cause more serious problems. Observing and addressing any such potential problems early is the best way to prevent future foot problems.
How to care for your feet?
Foot hygiene
- Wash feet daily with luke warm water and mild soap. Do not use hot water. Then, clean your feet and the areas between your toes until they are completely dry. Do not soak your feet as this may dry your skin.
- Trim your toe nails straight across. Do not dig under them or round the cuticle. File the sides of your nails with an emery board or nail file.
- Apply a moisturizing cream or lotion to the skin on your feet and to dry, brittle toenails. Use lotion that doesn’t contain alcohol and is unscented. Do not apply lotion between your toes.
Shoes and socks - Wear clean socks or stockings every day. Make sure they are not too tight.
- Do not wear knee-high stockings since they’ll decrease blood flow to your legs.
Wear shoes that fit properly with enough cushioning. - To use new shoes, wear them for just a few hours a day. This prevents injuries on your feet.
- Wounds, scrapes, corns, and calluses
- Check your feet daily for blisters, cuts, bruises, sores, and redness. If you can’t see rock bottom of your feet, use a mirror or ask someone for help. If any wound treat accordingly.
- Do not cut corns or calluses or attempt to remove them with medicine.
- If you find a minor scrape, cut, or break in the skin on your feet, keep it and the skin around it clean and dry, wash with mild soap and water. Do not use peroxide, alcohol, or iodine to clean the area.
Schedule an entire foot exam a minimum of once a year (annually) or more often if you’ve got foot problems. If you’ve got foot problems, report any cuts, sores, or bruises to your health care provider immediately.
This information isn’t intended to exchange advice given to you by your health care provider. Make sure you discuss any questions you’ve got together with your health care provider.
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