It is important to educate the diabetic patients on the complications of diabetic foot ulcers and their ensuing treatment and trauma. In this article, Dr. Leena Jain shares in detail upon the diabetic foot salvage treatment which focuses on saving the foot in the best possible manner.
The demand for diabetic foot salvage treatment is most likely to increase, considering India to have one of the highest diabetic populations in the world. There are high chances of diabetic patients developing foot ulcers, peripheral vascular disease, peripheral neuropathy, etc., which could lead to further complications to the extent of amputations.
Dr. Leena Jain, Mumbai’s leading Plastic, Reconstructive Microsurgeon & Hand surgeon, states, ‘As a reconstructive surgeon, I focus on diabetic foot salvage treatments with the sole aim to save the foot and retain the leg function that is ambulation. Diabetic foot salvage treatment is challenging and requires multimodality managementor an optimal outcome.’
Over the years, the rate of amputations has been steady due to a lack of awareness of foot salvage and lack of availability of reconstructive surgeons. Ulcers result from diabetes and diabetes related complications, poor footwear, and the habit of walking barefoot. The majority of these patients suffer from hypertension and dyslipidemia. Also, men face more risk of amputation than women.
Limb salvage treatment begins with foot evaluation, eradication of infection by surgery and dressings followed by replacing or resurfacing defects with healthy vascularized soft tissue.
It is essential to monitor and control blood sugar levels and other medical conditions to optimize the overall health of patient. Similarly, it is necessary to evaluate blood circulation in the lower limbs through a Doppler scan and angiography. Circulation needs to be restored by angioplasty when indicated before ulcer specific treatment is initiated.
The diabetic foot salvage treatment begins with debridement, a surgical procedure to remove the thick skin, dead tissues, pus, foreign debris, and affected soft tissues and dead infected bone. Suitable dressings and medication are essential to keep the wound moist and minimize the risk of infection.
Patients with infected foot ulcers, necrotising fasciitis, and osteomyelitiscan be life threatening if not treated timely. These conditions will need repeated debridementsto bring infection under control.
Once the wound shows signs of healing, reconstruction is planned. This involves coverage of foot defects with skin grafts or flaps which maybelocal,pedicledor free flaps as per defect requirement and suitability.
Limb salvage treatment is a multi-stage and multimodality procedure that includes debriement, drainage of infection, followed by reconstruction, and limb rehabilitation.
About Dr Leena Jain
Dr. Leena Jain is one of the leading Plastic, Reconstructive Microsurgeon and Hand surgeons in Mumbai with over seven years of experience who focuses on offering a holistic solution keeping in mind the patient’s recovery path to living normally.
She has acquired expertise in Reconstructive Microsurgery, Replantations and revascularizations, cancer reconstruction surgery, breast surgeries, facial nerve paralysis surgeries, deformity-corrective surgeries in burn patients, and many more.
Dr Leena Jain is available for consultations at Lilavati Hospital & Research Centre, Bandra and at her clinic in Vasudhan, Lancelot, C Wing, Second floor, S. V.Road, Borivali West, Mumbai, Maharashtra – 400092. Patients can email her at link.jain@gmail.com or call +91 98209 91853 for appointments.
