While foot wounds that can occur for different reasons can be healed with practical treatments, the presence of underlying diseases such as diabetes or atherosclerosis can complicate this treatment process.
While the recovery process is difficult, long and laborious in these patients, foot wounds can cause limb loss in some cases. Timely diagnosis and treatment of foot wounds is of great importance for the prevention of limb loss. Diagnosis and treatment is carried out with the joint teamwork of different departments such as Cardiovascular Surgery, Plastic Surgery, Orthopedics, Endocrinology, Infectious Diseases and Dermatology. In order not to encounter life-threatening situations, foot wound care should be taken seriously and treatment should not be interrupted. From Memorial Ankara Memorial Ankara Hospital Cardiovascular Surgery Department, Op. Dr. Fatih Tanzer Serter gave information about the foot wound treatments applied in the foot wound care unit.
Diabetes and arteriosclerosis are the most important causes
Diabetes and peripheral vascular diseases (atherosclerosis) are the main causes of foot ulcers. While the most devastating effect of diabetes occurs on the vascular system; Atherosclerosis causes progressive vascular damage that is difficult to heal with the effect of diabetes, can worsen with infections, takes time to care and treatment, and can also cause limb loss, and these injuries lead to foot wounds. Foot wounds, which usually start with minor injuries and can become life-threatening if not controlled, must be followed up.
Foot sores occur in 7 in 1 diabetic patients
Foot wound care should be taken seriously for diabetic patients. Diabetes, which is seen in 13,7 percent of the country's population, concerns more than 10 million people. However, one out of every 7 diabetic patients has a wound on their feet. Foot ulcer, which is more common in men than in women, is 1 times more common in Type 2 diabetes patients compared to Type 1,5 diabetes patients.
Foot wound treatment requires teamwork
After the foot wound has occurred, the treatment must be carried out with teamwork. Internal Diseases/Endocrinology, Cardiovascular Surgery, Dermatology, Infectious Diseases, Plastic and Reconstructive Surgery, Orthopedics and Interventional Radiology departments play an active role in the treatment process in foot wound care centers with suitable infrastructure. While the treatments of foot wounds differ according to the underlying causes, they are similar at some points.
Diabetic feet are infected and difficult to heal wounds
In the treatment of diabetic foot, surgical treatment of the appropriate/necessary patient group, increasing the amount of blood reaching the wound area with intravenous techniques or accelerating the capillary (capillary) circulation with drugs are the most critical steps of the treatment. After the wound is formed, the depth of the wound, abscess formation, dead tissue density determine the treatment plan and the abscesses should be drained as soon as possible and the dead tissues should be removed. In the presence of infection, the wound should be cleaned of harmful microorganisms with local and systemic antibiotic therapy and the possibility of possible sepsis should be eliminated. In appropriate patients, considering the wound depth, "Ozone therapy" support and orthopedic support can be taken in order to reduce the pressure/pressure in the wound area if necessary.
Increases circulation in the treatment of wounds caused by atherosclerosis.
In the patient group with foot wounds caused by peripheral vascular diseases, dry ischemic-gangrenous wounds are more common than abscess and infection formation due to the predominance of vascular occlusion. With the progression of the insufficiency of the arterial circulation over time, wounds and tissue losses called necrosis occur. In the treatment of these patients, increasing the arterial and capillary circulation is a priority, and a procedure similar to the diabetic foot treatment is applied in terms of wound care and removal of dead tissues.
Varicose ulcers due to venous insufficiency appear mostly as wet and infected wounds. These wounds are infected and difficult to heal, as in the "Diabetic foot" table. It requires good care and close follow-up. A multidisciplinary approach should be applied for the treatment of these wounds.
Precautions to be taken to prevent foot injuries
The points to be considered in order to prevent foot wounds caused by diabetes and atherosclerosis are as follows:
Foot care is important in diabetic patients. Appropriate moisturizer should be used to prevent the skin from becoming dry and cracking. Fungal infections that develop between the toes in excessively moist feet lead to deterioration of skin continuity and also creates a focus for infection.
- Deformities and calluses on the feet and fingers as a result of improper shoe selection should be avoided.
- Patients with impaired sensation as a result of uncontrolled blood sugar should not walk barefoot.
- Soft socks without additional seams should be used.
- Appropriate shoe selection should be made to prevent pressure points due to foot deformities caused by diabetes.
- In order to prevent infection, nail care should be done properly and unconscious pedicure procedures should be avoided.