amputation laparoscopic surgeon Dr Amita Jainamputation laparoscopic surgeon Dr Amita Jain

Surgeon Dr Amita Jain shares how to protect your feet from diabetic foot ulcers

Extreme diabetes conditions can trigger nerve damage and poor blood circulation that causes skin sores (ulcers). When the skin scores at the feet, it’s important to provide the patient with immediate care and proper diabetes management because a non-healing foot ulcer can severely damage the tissues and bone and it may require surgical removal (amputation) of a toe, foot, or part of a leg. Remember, more than 80% of amputations in diabetes cases, begin with foot ulcers.

Talking on this topic, India’s leading laparoscopic surgeon, Dr Amita Jain, shares that the good news is that proper diabetes management and careful foot care can help prevent foot ulcers. In fact, better diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 percent in the past 20 years. Dr Amita Jain shares some of the key points on foot ulcer.

Signs of diabetic foot ulcer:

  • Discolouration is one of the most noticeable signs of a foot ulcer. Black tissue called eschar often appears due to poor blood flow in the feet. Another kind of discolouration to look for is gangrene, it can range from pale to blue, purple, black, bronze, or red, depending on the type of gangrene in the foot.
  • Drainage from the foot wound is another noticeable sign of a foot ulcer.
  • When some area of the feet feels painful, tender, sensitive or firm to the touch.
  • Unusual Swelling – along with pain if there is swelling or irritation on the foot.

How to Prevent foot ulcers?

The best strategy for preventing foot ulcers is to adopt proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring, and adherence to a prescribed medication. The second strategy is to take proper care of your foot and ensure prompt medical care when problems occur. Tips for proper foot care include the following:

  • Inspect your feet daily. Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness, or swelling.
  • Don’t remove calluses or other foot lesions yourself or with the use of nail clippers or scissors on calluses, corns, bunions or warts.
  • Wear clean, dry socks. Wear socks made of fibers that pull sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation or socks with seams that could irritate your skin.
  • Quit smoking. Smoking impairs circulation and reduces the amount of oxygen in your blood. These circulatory problems can result in more-severe wounds and poor healing.

Factors that lead to an increased risk of an amputation

  • High blood sugar levels
  • Smoking
  • Nerve damage in the feet (peripheral neuropathy)
  • Calluses or corns
  • Foot deformities
  • Poor blood circulation to the extremities (peripheral artery disease)
  • A history of foot ulcers
  • A past amputation
  • Vision impairment
  • Kidney disease
  • High blood pressure

What if amputation is the only option?

The treatment for foot ulcers varies, depending on the severity of the score and damage of the ulcer. In general, the treatment employs methods to remove dead tissue, keep the wound clean, and promote healing. However, when the foot score results in a severe loss of tissue or a life-threatening infection, amputation could be the only option to save the patient.

A surgeon will remove the damaged tissue and preserve as much healthy tissue as possible. Post-surgery, commonly the wound takes four to six weeks to heal completely.

However, even after amputation, it’s important that the patient follows the diabetes treatment plan, controls his/her blood sugar level, and avoids tobacco to prevent additional diabetes complications.