Among the symptoms of diabetes, which is among the diseases of today, there are small wounds in the feet. Especially diabetes patients should pay great attention to foot care. Many diseases have important points that people should pay attention to. Diabetes patients also need to take care of foot care, otherwise foot injuries may be replaced by serious questions. Department of Infectious Diseases and Clinical Microbiology, Fırat University Medical Faculty Hospital about diabetes disease and its symptoms. Lecturer. Member Şafak Özer Balın shared information about the diabetic foot wound.
Attention to Foot Wounds in Diabetes Disease!
According to the International Diabetes Federation data, diabetes, which has a global incidence of 9 percent, is an important public health problem that causes death at an early age and negatively affects the quality of life if it is not controlled. It is predicted that 642 million people worldwide will have diabetes in 2040. Foot sores seen in diabetes patients have serious consequences for both the patient and the health care system.
Diabetes, which is a chronic metabolic disease characterized by hyperglycemia due to insulin deficiency or defects in insulin effect, characterized by hyperglycemia, is considered as one of the most important health problems in the world today. Diabetic foot wounds can have serious consequences for both the patient and the health care system.
Wounds on the Foot Are Growing!
While the risk of diabetic foot injury is in one out of six patients with diabetes in developed countries, this rate is much higher in developing countries. These wounds may be due to nerve end damage, paralysis, or ischemic origin, that is, a regional decrease in blood flow or a part of the body not getting enough blood and oxygen.
In addition, hyperglycemia, the increase in blood sugar in the body, increases the tendency to infection in various ways. Superficial wounds caused by ischemia, uncontrolled hyperglycemia, and recurrent traumas progress to osteomyelitis, which we call deeply located abscess and bone inflammation. Increased ulcer susceptibility in areas such as feet and legs in diabetic patients, disorders in the immune system, damage to the nerve endings, circulatory failure (in the blood vessels), presence of large or minor traumas, duration of diabetes, impaired glucose control, increased pressure on the foot, Charcot Factors such as the development of joint deformity, smoking, or the patient’s overweight.
You may not be aware of standing wounds!
Peripheral neuropathy seen in patients with diabetes is often in the form of sensorimotor neuropathy. It is symmetrical, chronic and decentralized and more prominent on the lower leg; It shows up in the form of socks. In addition, since it changes the walking biomechanics, it causes thickening of the skin seen in the sole of the sole and all the sole pressure is concentrated at one point.
The absence of a sense of pain in these patients prevents natural protection, that is, not pressing on the lesion. This can lead to wound development. Also, minor trauma in these patients, such as inappropriate shoes, burns, incisions, insect bites, can easily develop chronic wounds. Loss of pain sensation delays the diagnosis by causing the patient to apply to the doctor late.
Foot Wound Helps Control Diabetes!
Diabetic foot wound can often be prevented by providing patient foot care and controlling diabetes. Serious complications or limb losses can be prevented by detecting and healing a wound that occurs most of the time, or by taking an early and appropriate antibacterial approach in the presence of an infection.
A multidisciplinary approach is required for proper diagnosis, effective treatment and follow-up of diabetic foot wound and infections and to prevent unnecessary amputations. Patients with diabetic foot wounds should first consult an infectious diseases specialist and endocrinologist, and if necessary, should be evaluated with the opinion of a surgical branch (plastic surgery, orthopedics), vascular surgery and dermatology specialist.
Don’t Hinder Therapy!
In the treatment of diabetic foot infection, the general treatment approach to provide wound healing and to save the leg involves the removal of dead and infected tissues with urgent and aggressive debridement, early initiation of appropriate antibiotic therapy and ensuring metabolic control. The purpose of the treatment is to prevent progressive tissue damage by stopping the infection. Antibiotic therapy is required in all infected wounds. Although antibiotic treatment is necessary in all infected wounds, it should be performed with appropriate wound care. Treatment should be started as soon as possible after the clinical diagnosis is made.
Thus, the rate of infection-related disease, length of hospital stay, and large foot amputations are reduced. The duration of treatment varies between 7-10 days in mild infections, 2-3 weeks in moderate infections, and 2-4 weeks in severe infections, not until the wound is completely healed. The duration of treatment in acute bone inflammation should be considered for 4-6 weeks, at least two weeks from the vascular access, and in chronic bone inflammation, at least three months if the infected bone tissue cannot be removed.
Take Care of Daily Foot Care!
Early wound care and, if necessary, antibacterial treatment can prevent the wound from progressing and thus cutting the foot. The diabetes-induced amputation patient had a high risk of death, and the 5-year mortality rate was determined to be 70 percent. In order to prevent diabetic foot infection, a good glycemic control is required first. Education of high-risk individuals and families, relief of the foot from load and pressure, assessment of the vascular structure of the foot and local wound healing should be ensured.
The foot care of these patients should be done daily by washing the feet and especially between the toes and applying moisturizing cream, not walking with bare feet, using suitable shoes and socks, nails should be cut properly and problematic nails should be checked continuously. In addition, callus treatment should be done carefully; shoes inside should be examined daily, socks should be changed daily and in cases such as foot fungus, incision, abrasion, wound, it is necessary to apply to the health institution without delay.