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Diabetic foot problem: amputation – to be or not to be?

25 Jun 2012, 17:47
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Suppuration and necrosis of soft tissues of the foot and toes caused by nerve and vascular lesions called diabetic foot. As we can see from the name of the article the given problem is manifested in people with diabetes. Tissues and skin is quite sensitive to injury because this disease reduces the immunity and lead to a poor wound healing. Moreover, diabetes causes a lesion of the peripheral nerves and arteries.

diabetic foot

Sequential treatment of diabetic foot

  1. The elimination of critical ischemia and improving of blood circulation. Autovenous microshunting is the most effective method of normal blood circulation restoring. During the operation new vessels previously created on the base of patient`s vessels are conducted through the effected by the disease arteries.
  2. Endovascular method. Conductors are putted in the artery through a puncture. They have an ability to inflate narrowing with a special balloon, thereby restoring patency of the arteries.
  3. Compensation of immunity disorders and diabetes. Patients with diabetic foot should take an insulin and group B vitamins, which has ability to assimilate of glucose. Than all the metabolic systems, blood flow and clotting are correcting. Antibiotics and immunomodulators are prescribed. The correction of heart and kidneys is also needed.
  4. Operation. Tissues which are exposed to suppuration and necrosis removed surgically. After that the wounds should be cleaned. Skin defects, which can be a result of operation, are eliminated with the help of plastic surgery.

 

Diabetic gangrene

 

Diabetic gangrene is a severe form of diabetic foot. It may be caused by anaerobic infection, which, in turn, is a result of serious lesion of an ankle. In this case gangrene is developing very active and even may cause a death of a patient in a few hours. Sometimes a wide necrectomy may be the only way to save a patient. This is an emergency surgery for removing dead tissue. After this operation an extracorporeal detoxification is used to deduce the patient from the serious conditions. When the patient is in a stable condition doctors restore a blood flow and perform foot plastic.

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