Diabetic foot - Signature Care

What’s Diabetic Foot?

Diabetic patients suffer from the problem of the diabetic foot & its ulcers that may arise in them as one of the complications resulting from the loss of control of blood sugar levels, in addition to neglecting to abide by food diets and not taking medications at the prescribed scheduled times and according to the appropriate doses. It is indicated that diabetic foot affects one patient out of every 10 diabetics at some point in their lives.

Diabetic foot problems are considered to be one of the most common complications of diabetes. They’re Skin Ulcers due to the injuries of the foot without the patient feeling it; as the continuity of high levels of blood sugar without controlling it leads to damage to the peripheral nerves or a decrease of blood supply (flow) to the feet, so the diabetic patient loses feeling in his feet if they are (injured or wounded).

The wounds and cracks in the foot of a diabetic patient become a hotbed for the things that cause inflammation, to ulcerate, (aggravate & gradually worsen), so the cells and tissues die at the site of the inflammation and may spread to include the fingers, foot, and part of the leg, in what is known as Gangrene, it may also cause deformities in the foot resulted from the affected bones and many other parts of the leg and foot.

The Diabetic foot should be treated if the problem is noticed and consult a specialist to take the necessary measures and avoid the most difficult solutions that may end up in the )Amputation of one of the fingers or perhaps the entire foot) fearing that the problem spread to the leg.

When should you visit the doctor?

A diabetic patient may resort to seeing a specialist in case of signs appear on the foot that requires medical intervention and indicate a diabetic foot, including:

• Swelling of the foot and ankle
• Ulcers and wounds on the feet
• Change in the color of the skin on the foot and sometimes, appearing off a black or red area surrounding the affected area
• Nails look yellow and thicken, or they may grow inward
• Strange smell coming from the feet
• Dryness and wrinkling of the skin on the (heel of the foot)
• Pain in the feet or legs
• Numbness accompanied by a lack of feeling in the feet, including the fingers, and perhaps the legs as well
• Hair loss from the feet or legs
• Foot infected with (types of infections caused by fungi)
• Hotness in the feet

Treatment of Diabetic Foot

A group of treatment options can be followed to control the condition of the diabetic foot, depending on the patient’s condition and the extent (aggravation) of the problem. Treatment is either through surgical or non-surgical procedures.

Diabetic foot treatment methods include:

• Cleaning of the wounds, ulcers, and draining accumulated fluids and pus under the supervision of a specialist.
• Oral or intravenous Antibiotics kill certain types of aerobic and anaerobic pathogens.
• A surgical procedure to remove dead tissue and get rid of ulcers and wounds in the affected foot.
• Performing an operation for the diabetic foot in case of (loss of blood supply), which includes installing a shunt into the arteries to enhance blood flow to the affected area of the foot.
• Performing a Surgical procedure for the diabetic foot that includes installing stents (networks) inside the arteries to keep them open so that blood flows well towards the foot, which helps speed up the healing of wounds and ulcers.
• In cases of severe injury in which the damage reaches the deep tissues up to the bones in the foot, the surgeon may then resort to amputating the affected fingers or foot, or even part of the leg. It is reported that 80% of amputation cases in diabetic patients begin with neglected foot ulcers.

Surgical procedures for the treatment of advanced diabetic foot conditions

Vascular repair operations in the diabetic foot include:

Installing stents to open the arteries of the foot:

It is a surgical procedure aimed at opening the blocked arteries in the foot using a balloon, as the vascular surgeon inserts stents that can keep the arteries open to the flow of blood circulation towards the foot, this procedure is done under the influence of general or regional (Spinal) anesthesia, and some patients can leave the hospital on the same day, but sometimes their condition requires a slightly longer stay.

Arterial shunt to increase blood flow to the foot:

It is a surgical procedure that aims to divert the flow of blood circulation by changing the path of blood to avoid closed arteries and pass through a new shunt that facilitates blood access to the foot, so the wounds begin to heal and recover.

The arterial shunt operation can be performed under the influence of general or regional (Spinal) anesthesia, the patient remains under medical observation for a day or more depending on his condition & according to the specialist’s recommendations.

Early Examination

An early comprehensive examination of the feet includes:

• Examination of peripheral neuropathy of the extremities
• Ensure the safety (integrity) of muscles & bones
• Examination of the skin of the feet
• Measurement of blood perfusion using the ABI device (Ankle-brachial index), under the supervision of a medical team specializing in diabetic foot

Symptoms of diabetic foot:

• Wounds that don’t heal
• Swelling in parts of the foot
• Weakness or lack of feeling in the foot
• Pus coming out of the foot
• Blueish or blackening of the toes or sides or soles of the foot

What are the methods of prevention for diabetic foot ulcers?

• Routine personal examination at home and routine visits to the specialist doctor to examine the foot and take blood perfusion measurements.
• Wear suitable shoes for diabetics and make shoe padding (filling) to prevent friction.
• Controlling blood sugar levels to prevent complications
• Quit smoking
• Daily exercise such as walking for 20-30 minutes

What’s the ideal behavior when foot wounds occur in diabetic patients?

Negligence in dealing quickly with diabetic foot wounds may lead to amputation of one or all parts of the foot, God forbid, so you must act ideally & as quickly as possible.

First, make sure that there is no sharp object in the foot (thorn, needle), then sterilize the wound area with wound disinfectant, then put gauze to cover the wound and not expose it to air & dirt on the ground to prevent bacteria from reaching the wound.

Secondly, go to the diabetic foot clinic as soon as possible or to the specialist foot doctor for examination and treatment by cleaning the wound and dispensing the appropriate antibiotic.

Examinations may include radiology of the foot, laboratory tests, and catheterization of blood vessels in case of (narrowing or blockages detected in one of the main arteries in the leg).

Negligence in dealing quickly with diabetic foot wounds may lead to amputation of one or all parts of the foot, God forbid.

Our Services for diabetic patients in the (Diabetic Foot Unit) at Signature Care Clinics:

• Treatment of gangrene cases
• Cleaning and treatment of foot wounds
• Treatment of foot ulcers
• Treatment of foot fungi
• Treatment of foot nerve inflammation
• Examination of blood perfusion in the foot

Complete care for the diabetic foot, starting from treating foot wounds to treating gangrene cases and preventing diabetic patients from amputation…

Diabetic Foot Unit Services:-

• Examination of neuropathy in the feet
• Measurement of blood perfusion in the feet
• Treatment of gangrene cases
• Treatment of blocked arteries
• Treatment sessions for skin cracks and nail cutting (clipping)
• Treatment of diabetic foot wounds and ulcers

The appropriate treatment varies according to the patient’s condition and is determined after diagnosis and radiology

1. Varicosis injection (Sclerotherapy):

Some of the veins that cause varicosis or visible capillaries, are under the skin and cannot be seen with the eye. The doctor can & without the need for a surgical incision, insert a needle into the veins (under the guidance of ultrasound), and then inject the veins, which leads to the disappearance of varicosis or the visible capillaries.

2. Endovenous Laser Ablation Therapy (ELVT) and Thermal Frequency; Radiofrequency Ablation (RFA)

The modern alternative way to surgery that takes place in the clinic within an hour, treats diseased varicose veins

• Without general anesthesia or pain
• Without hypnotizing the patient
• Without fasting before it

Catheterization has proven to be very successful in treating varicose veins, with a success rate of 97%.

Catheterization method: The specialist doctor inserts a fine (precise) catheter tube through a very small hole in the skin. The wall of the Saphenous vein is thermally heated by laser or radiofrequency, which leads to adhesion of its wall, cancelation of its cavity (lumen), and then its fibrosis weeks later and getting rid of blood reflux in it.

3. The latest treatment of varicosis (Superglue)

• The patient doesn’t need medical socks after the treatment
• The patient feels better immediately
• Without repeated anesthesia needles
• Without bruises or pain

Without using heat, it uses medical glue technology