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Diabetic Foot Problems

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People with diabetes have high levels of glucose in the blood stream for a long period of time, and this uncontrolled glucose level can cause damage to the nerves in your legs and feet. You may not feel heat, cold or pain when you have an injury to your foot and the loss of these sensations is referred to as diabetic neuropathy. As a diabetic there is a higher risk of skin infections, ulceration, and destruction of deep tissue.  Appropriate assessment and management of diabetes-related foot ulcers and infections is essential to reduce the risk of amputation. Diabetics are usually referred for vascular assessment, with the appearance of a diabetic foot ulcer, to correctly identify the type of the ulcer you are suffering: purely neuropathic, ischemic related due to decreased blood flow, or mixed neuro-ischemic origin. By ruling out ischemic origin this reduces the high risk of amputations and limb loss. Even minor trauma to the diabetic foot can result in gangrenous wounds on toes and the foot.

Role of the vascular surgeon

  • Regular ongoing wound assessments
  • Assessment for atherosclerotic occlusive disease
  • Debridement of non-viable tissue from wound as necessary
  • Surgical debridement and drainage of any infected or gangrenous tissue
  • Restore maximal perfusion of blood to the foot by either endovascular procedures like angioplasty/stenting or bypass surgery if indicated, to avoid limb loss

Your surgeon will discuss any necessary treatment with you at your clinic appointment

If your ulcer is non ischemic please click the link below for information on the management of venous ulcers