Diabetic Foot Care
A Special Clinic for Diabetic Foot Care
A recent study of the health profile of India has found that the incidence of diabetes is on the increase. 8% of the people are found to have diabetes taking the whole population into account. By 2025 it is estimated that there will be about 69.9 million diabetics in India giving it the title "Diabetic Capital of the world".
The drugs available present day has helped to manage diabetes as early as possible. The complications of diabetes increases the mobility and sometimes the mortality. Foot ulcers in diabetes fall into that category. It has been found that 15% of people with diabetes develop a foot problem sometime in their life time. This is an exclusive problem of India.
WHO statistics has found that in every 30 seconds one lower limb is amputated due to complications in diabetes. This statement is alarming; the silver lining is that so much of the foot complications with diabetes are preventable. Even if complications happen, if seen in the earlier stages many of them can be salvaged from amputation. This requires a team work which is able to deliver comprehensive care with Diabetologists, Reconstructive Microsurgeons, Vascular Surgeons, Anesthesiologists, Pain Relief Specialists, Dietitians and Skilled Footwear Specialists under one roof. Very often these patients require continuous and regular follow-up and the presence of a focused team will make all the difference to reduce salvage and failure.
Ganga Hospital Diabetic Foot Care Clinic
The Plastic and Reconstructive Surgery Department at Ganga Hospital has pioneered the scope and growth of Reconstructive Surgery and is the first to introduce Microsurgery to this region. The work has improved the outcomes in trauma reconstruction, brachial plexus surgery and burns. The Department has keen interest in the management of diabetic foot wounds for the last decade and now for the first time has come out with a dedicated sector managing this problem. It has been our experience that the provision of adequate surgical care followed by appropriate post operative protocol and surveillance, very much reduce incidence of recurrence. Prevention of the problem and recurrence of foot ulcers will enormously add to the quality of the life of the individual and also result in good economical savings. It is with this interest that this Center has been created. The Diabetic Foot Care team and the Surgical team supported by the Aneaestheologists and a special unit for manufacturing foot wear is ideally suited to deliver the required care.
What Causes Foot Problem?
As patients are known to have microangiopathy which means that small blood vessels get blocked reducing perfusion. Diabetics in addition may also have afflictions in nerves resulting in reduction of sensation in the foot. The diabetic foot devoid of sensation, it is susceptible for injury during even simple activities as a daily evening walk. When there is reduction in blood supply it results in poor healing of the wound. The key is to prevent this from happening.
At this specialized center we have installed a pedoscan which measures the dynamic foot pressure changes that happen during walking and while standing . This level of sophisticated equipment is used only in very few centers in the country. We are proud to say that we are one of the very few centers with this computerized equipment assisted with automated footwear designing and manufacture. This technologically advanced footwear is very much different from the MCR footwear available in the open market. This will help to reduce the foot associated complications of diabetes.
In a selected population it has been found that nerves supplying sensation to the sole of the foot are compressed around the ankle. The compression reduces the blood supply to the nerve and prevents it from functioning. Diabetic care and release of the ligaments is found to be very useful in improving sensation and detecting foot problems in susceptible people. This procedure is called Tarsal tunnel release and the surgical team is regularly performing this procedure.
Care of Foot Ulcers
In case ulcers develop, they have the tendency to spread very far. This is more so in people who have got reduced blood supply to the foot. Treatment involves removal of non-viable tissues. This procedure is called debridement. When the radical debridement is required it might result in loss of tissues, and this requires skilled plastic surgical expertise to reconstruct and restore the loss with tissue from other regions. The team at Ganga Hospital is well suited to this.
Post - Operative Rehabilitation
Reconstructed foot requiring special footwear which would need off loading of weight in sensitive areas and vulnerable pressure points. Enhanced manufacturing facilities has been created to do special footwear for these people. This will be a great asset and be a value to people undergoing reconstruction. These people also require specialist physiotherapy to make them ambulant again and the experienced physiotherapist team at Ganga Hospital will render these services.
Overall Diabetic Care
Care of the Diabetic Foot depends on a good control of diabetes and all these people will be managed by a team consisting of a senior Diabatologist, Cardiologist, Nephrologist, Anesthesiologtists and other physicians. The Diabetic team will be responsible for the care of these patients and after surgery. They will also be assisted by dieticians and counselors.