Diabetic Foot and Chronic Wound Problems

Podiatric medicine deals with diseases of the feet, toes, ankles and soles of the feet. Podiatric care includes treatment of nail disorders, bunions, hammertoes, heel pain and thickened skin. Taking care of the feet can help reduce pain, inflammation and improve the patient’s quality of life.

Debridement is often recommended to treat diabetic foot ulcers. The procedure involves removing dead or infected tissue and pus around the wound surgically. Debridement helps restart the healing process and reduces inflammation, pain and chances of re-infection. It also helps minimise scarring.

Nerve decompression surgery is used to treat the complications of diabetic peripheral neuropathy (DPN). Diabetic peripheral neuropathy causes a tingling sensation or numbness. Surgery is only recommended for patients with DPN when medication and non-invasive therapies have proven ineffective. Depending on the location of the compressed nerve, the surgeon may choose to operate using minimally invasive techniques or open techniques. The patient may experience some pain following the surgery. Evidence says that nerve decompression could partially recover the sensation and also prevent deterioration of the existing sensation. Nerve release procedures for Diabetic foot are commonly done for common Peroneal Nerve below the knee, Superficial Peroneal nerve on the lateral aspect of leg and Posterior Tibial Nerve in the ankle.

Diabetic foot ulcers are prone to infection, inflammation and extreme pain. The wound can get large and may require surgical closure if it fails to heal using more conventional treatment methods. The surgeon may use a skin graft to cover the wound. A local flap or a microvascular free skin flap may be used for the procedure.