The news that India is likely to be the diabetes capital of the world has been going around for a while. Diabetic patients are at a unique risk of developing foot wounds whenever the skin barrier is breached due to injury and disease.
An optimal environment must be provided to support the essential biochemical and cellular activities required for efficient wound healing and to protect the wound from factors that impede the healing process. The most important factors that influence wound healing are:
Nutritional status of the patient
Presence of infection or contamination of the wound
Diseases like diabetes, varicose veins and reduced blood supply
Once such a wound is formed on skin, it progresses through various phases and generally heals with a scar. There are occasions when these wounds fail to heal in spite of treatment for 4 to 6 weeks. These wounds are referred to as chronic ulcers. The management of these ulcers requires expertise and attention to detail. It is important that all wounds are attended to appropriately at the earliest. Often delay in seeking proper advice is the most important reason for non-healing of wounds. Care of diabetes and early recognition of ulcers are the cornerstones in the successful prevention of chronic ulcers.
The concept of wound management clinics and wound care specialists in the developed world has helped many patients to save their limbs and have a functional life.
How does a modern wound management centre deal with non-healing wounds?
Cleanse and decontaminate wounds with the help of a procedure called ‘debridement’. The ‘Advanced Wound Care Centre’ at QRG Health City is equipped with ‘hydrojet debriding unit’ that uniquely removes unhealthy tissues and saves injury to healthy tissues.
Once the wound is cleared of unviable tissues, it is subjected to ‘Negative Pressure Wound Therapy’. This process has revolutionised wound healing by shortening the period of healing. Our ‘Advanced Wound Care Centre’ has helped hundreds of patients with the use of this therapy to attain a functional life at the earliest. This therapy helps in either healing the wounds completely or in helping prepare a bed for the wound to receive a skin graft. The last part of the management is to provide skin cover by means of stitching the edges together or by use of different types of skin grafts.
Another very important aspect of wound management is to improve nutrition of the patient & improve blood supply to the limb. The latter may require interventions like angioplasty and bypass operations.
How can diabetic foot ulcers be prevented?
Check your feet daily: People with diabetes are less aware of pain in their feet due to decreased sensitivity, it’s important to keep an eye open for cuts, cracks, blisters and other signs of the beginning of a wound.
Keep your feet clean: Wash your feet everyday with mild soap and lukewarm water. Dry them gently with a towel and moisturise on the top and bottom of feet and use talcum powder between the toes.
Choose the right shoes: Your footwear should be tight enough to keep the fabric from rubbing against the skin and causing diabetic foot ulcers, but loose enough to be comfortable and not crowd the toes.
Don’t smoke: Smoking greatly reduces circulation, which can increase your blood flow issues in your feet.
Get regular check-ups: People with diabetes should have a foot examination by a wound care specialist at least once per year. During these appointments, the specialist inspects your feet for circulation issues, early signs of nerve damage and other foot problems that could potentially lead to infection and eventual loss of limb if it is neglected.
- DR PRABAL ROY
Director - General and Minimal Access Surgery
OPD Timings : Mon-Sat 10, 10 AM-5PM
QRG Health City, Sector 16, Faridabad