Diabetic Foot

Diabetic Foot 

When a diabetic foot requires extensive repair, surgeons may perform reconstructive surgery. This involves specialized procedures to restore and improve the foot’s structure, helping to address issues caused by diabetes and enhance overall foot health.

How can diabetes contribute to foot problems?

Diabetes patients frequently experience foot difficulties. They can develop over time as a result of excessive blood sugar damaging the nerves and blood vessels in the feet. Diabetic neuropathy, or nerve damage, can cause numbness, tingling, pain, or lack of feeling in your feet.

You may not notice a cut, blister, or ulcer (open sore) on your foot if you can’t feel discomfort. Such a wound could become infected. Because damaged blood vessels might cause inadequate blood flow in your foot, the infection may not heal properly.

Gangrene can develop as a result of an infection and insufficient blood flow. This causes muscle, skin, and other tissues to perish. If you have gangrene or a foot ulcer that does not improve with treatment, you may need to have your foot amputated. This is a surgical procedure that involves removing a damaged toe, foot, or portion of your leg. It may prevent the spread of a dangerous infection and save your life.

However, there is a lot you can do to keep a foot wound from becoming a severe health issue.

How can I protect my feet if I have diabetes?

Taking proper care of your feet is crucial if you have diabetes, as diabetes can lead to complications that affect the nerves and blood vessels in the feet. Here are some key steps to protect your feet:

1. Control Blood Sugar Levels: Keep your blood sugar levels within the target range recommended by your healthcare provider. This helps prevent or slow down nerve and blood vessel damage.
2. Daily Foot Checks: Inspect your feet every day for cuts, redness, swelling, and any changes in skin color or toenails. Pay attention to any warts or spots that could be irritated by your shoes. Check the bottoms of your feet using a mirror if needed.
3. Regular Washing: Wash your feet daily with mild soap and warm water. Avoid soaking your feet for too long, as it can dry out the skin. Make sure to dry your feet thoroughly, especially between the toes.
4. Moisturizing: Apply moisturizer to keep the skin of your feet soft and prevent dryness. However, avoid applying lotion between your toes, as this area needs to stay dry to prevent infections.
5. Corns and Calluses: Consult your doctor on how to safely remove corns and calluses. Do not attempt to cut them yourself, as improper removal can lead to skin damage.
6. Proper Nail Care: Trim your toenails straight across with a clipper. If you have difficulty doing it yourself, seek the help of a podiatrist. Avoid cutting the corners of your nails to prevent ingrown toenails.

7. Footwear: Always wear well-fitting shoes and socks to protect your feet. Avoid walking barefoot, even indoors. Make sure your shoes have a smooth interior, and choose socks without seams or bumps.

8. Protection from Temperature Extremes: Protect your feet from extreme temperatures. Use sunscreen on exposed skin when outdoors and avoid walking barefoot on hot surfaces. In cold weather, wear warm socks and avoid warming your feet directly by heaters or fireplaces.
9. Maintain Blood Flow: Keep blood flowing to your feet by elevating them when sitting, wiggling your toes, and doing foot exercises. Avoid tight socks or footwear that may restrict blood circulation.
10. Regular Foot Exams: Schedule regular foot exams with your healthcare provider, even if you haven’t noticed any issues. A healthcare professional can identify potential problems early and provide appropriate care.

Diabetic Foot Complications
If you have diabetes, call your doctor if you have any of the following symptoms:

• Skin pigmentation changes
• Skin temperature fluctuations
• Inflammation of the foot or ankle
• Ache in the legs
• Foot ulcers that are sluggish to heal or are draining
• Ingrown toenails or fungus-infected toenails
• Calluses or corns
• Dry skin cracks, particularly around the heel
• Foot odor that is unusual or persistent

PROCEDURES:

1. Callus excision
2. Offloading
   1. External offloading
   2. Internal offloading- capsulotomy, wedge osteotomy, condylectomy to remove the pressure points intrinsic to the ulcer.
3. Tendon surgeries-
   1. Tenotomy- for Flexor hallucis longus and flexor digitorum longus to correct hammer toes, causing ulceration over tip of toes
   2. Lengthening of the extensor tendons of toes
   3. Tendoachilles lengthening
   4. Tendon transfers
4. Local flaps
5. Microsurgery and free tissue transfer
6. Vascular interventions-
   1. Angioplasty
   2. Surgical bypass