Diabetic Foot & Gangrene
Diabetes damages the body’s small blood vessels (microvasculature), impairing blood flow, delaying wound healing, and causing nerve damage known as peripheral neuropathy.
As sensation decreases, injuries may go unnoticed, allowing even small cuts or blisters to progress into chronic, non-healing ulcers or severe infections such as gangrene.
What Is a Diabetic Foot Ulcer (DFU) and Gangrene?
Diabetic foot describes a group of foot complications that occur due to long-standing uncontrolled blood sugar levels. Over time, diabetes damages small blood vessels, reducing blood flow to the feet and compromising tissue health.
Diabetes also causes nerve damage (peripheral neuropathy), leading to reduced sensation and an inability to feel pain, pressure, or minor injuries. As a result, small cuts, blisters, or wounds may go unnoticed.
Poor circulation combined with high blood sugar increases the risk of infection and delays healing. If not treated promptly, these injuries can progress into chronic, non-healing ulcers and, in advanced cases, develop into gangrene (commonly referred to as “black foot”), where tissue death may necessitate amputation.
DFU Signs & Symptoms
Diabetic foot complications often develop slowly as a result of glycation—a process in which excess blood sugar binds with fats and proteins in the bloodstream to form advanced glycation end-products (AGEs).
These AGEs accumulate in blood vessel walls, particularly in arteries, leading to narrowing, stiffness, and reduced blood flow. This impaired circulation sets off a chain of changes that gradually worsen and contribute to the progression of diabetic foot problems over time.
Poor Blood Flow
- Reduced blood flow causes cold or pale feet, slow healing of cuts or injuries, and hair loss on toes and feet.
- Poor circulation increases vulnerability to ulcers and infections, making early detection essential.
Numbness or Tingling
- Reduced oxygen and nutrient supply to nerves leads to nerve damage (diabetic neuropathy).
- Patients may experience numbness, tingling, or reduced sensation in the feet.
- Pain from cuts or minor injuries goes unnoticed, increasing the risk of infection.
Skin Changes
- Poor blood supply reduces skin nutrition, making it dry, cracked, or brittle.
- Calluses, thickened toenails, redness, or unusual warmth may develop, signaling inflammation or infection.
Foot Deformities
- Nerve and muscle damage can alter foot structure and shape.
- Clawed toes, bony prominences, or Charcot foot may develop.
- These deformities increase pressure points, disrupt walking patterns, increasing the risk of ulcers.
Foot Ulcers
- Open sores or wounds often appear on pressure points like toes, heels, or the soles, and heal very slowly.
- Untreated ulcers can deepen, become infected, and lead to severe complications.
Gangrene
- When blood supply is critically reduced & infections are untreated, tissues may die, causing gangrene.
- Foot appears black or dark, feels cold or numb, and require urgent medical attention to prevent amputation.
Treatment Options for DFU
The goal of treatment is to promote wound healing, improve circulation, and reduce the risk of gangrene or amputation.
Preventive Measures
- Maintaining stable blood sugar levels supports faster wound healing and prevents further damage to nerves and blood vessels.
- Examine and clean your feet daily, especially between the toes. Early detection of wounds helps prevent severe infections.
- Keep the feet dry, wear cotton socks, and avoid walking barefoot to minimise injury and infection risk.
Offloading Footwear
- Offloading redistributes body weight evenly across the foot using specialised footwear or insoles to reduce pressure on ulcer sites.
- At Swasthyam Superspeciality Hospital Diabetic Foot Clinic, we provide custom-made footwear designed to offload pressure points, promote faster healing, and maintain a balanced gait.
Compression Stockings
- Wear compression stockings during the day as advised to improve venous return and reduce swelling.
- We understand that standard stockings can be uncomfortable, which is why at Swasthyam Superspeciality Hospital, we provide custom-made stockings tailored to your measurements.
Compression Therapy
- Multi-layer compression dressings (such as 3-layer or 4-layer systems) help prevent blood pooling in the legs and enhance circulation.
- Lymphapress therapy may also be used to improve lymphatic drainage in patients with chronic swelling or venous insufficiency.
Advanced Wound Care
- Specialised dressings such as hydrocolloid, foam, or antimicrobial dressings are selected based on wound depth, discharge, and infection risk.
- Regular dressing changes and close monitoring promote tissue regeneration and prevent infection spread.
VAC (Negative Pressure Wound Therapy)
- VAC therapy uses gentle suction to remove fluid and infection from the wound site.
- It stimulates healthy tissue formation, accelerates healing, and reduces the frequency of dressing changes.
PRP (Platelet-Rich Plasma) Therapy
- PRP uses your own blood components rich in growth factors to boost healing in chronic or ischemic ulcers.
- It enhances tissue regeneration and microcirculation in areas with poor blood flow.
Surgery
- Surgical options may include debridement (removal of dead or infected tissue) or correction of deformities that create pressure points.
- In advanced cases, surgery may be performed to remove arterial blockages and preserve limb function.
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