Diabetic foot

Vascular diseases, pathological problems, infections and neuropathy are the fundamental pillars where the etiopathogenesis of the lesions generated by the diabetic foot can bring serious consequences to the patient.

Diabetes is the main cause of the appearance of ulcers and skin lesions in about 25% of patients. This is due to the involvement of blood vessels, nerves and epithelial tissue. In general, these patients who, due to their own pathology, have a high risk of suffering from infections, complicating their treatment.

In addition to the high chances of an infection spreading to the entire foot, circulatory and metabolic disorders are the order of the day, so systematized therapy with antibiotics will always give good results.

To avoid this, proper drainage of the foci of infection and meticulous debridement of the lesions are the measures par excellence against diabetic foot infections.

Levels according to severity of injury:

•Grade 0:

Hyperkeratosis, calluses or calluses accompanied by cracks on the skin.

Deformities, hallux valgus, hammertoes, pes cavus, etc.

Incarnate nail: It is mandatory, the nails should never be cut but filed and the shoes should not press the fingers.

Mycosis, athlete’s foot: When it appears, it is usually between the toes and on the sole of the foot. Reddened area with maceration and rupture of the skin tissues.

•Grade 1:

Superficial ulcer.

•Grade 2:

Deep ulcer: Injured foot, possibilities of infection that affects local areas such as cellulitis, lymphangitis, crepitus, bone involvement, purulent exudate, bad smell, notable depth, fistulas, gangrene, etc.

It requires meticulous surgical debridement to remove dead tissue, including hyperkeratosis covering the wound.

Given these signs of topical infection, the use of dressings with silver, silver sulfadiazine, antimicrobials, and absorbent dressings such as hydrocolloid hydrofiber and alginates are indicated.

When these types of ulcers do not present a correct healing evolution, they are signs of possible osteomyelitis.

•3rd grade:

When signs of cellulitis, abscesses, osteomyelitis or signs of sepsis are present, the patient should be hospitalized for surgical debridement and urgent treatment with parenteral antibiotics.

•Grade 4:

Gangrene in one or more toes.

Immediate medical intervention, hospitalization, by-pass, angioplasty or amputation.

•Grade 5:

Gangrene in the foot.

 


Comprehensive treatment and an etiological diagnosis recommend local therapeutic measures for the patient with diabetic foot, each case must be considered separately because each patient offers us different approaches to heal.

The integration of new therapies and products such as hydrogels, alginates, hydro fibers, silver dressings, growth factors, collagen, etc. They have given patients and nursing staff effective solutions for these types of injuries.

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