Diabetic foot is a skin lesion caused by thrombosis of the microcirculation of the foot called diabetic microangiopathy. The primary sign of diabetic foot is the appearance of a wound usually on the sole of the foot and located over an area of “callus” with hyperkeratosis that rapidly ulcerates. This wound can also be found in other locations such as in the interdigital folds or the balls of the toes (although these lesions are not etymologically called “diabetic foot” they are due to the same cause).
In any case it is very important to see a specialist in Angiology and Vascular Surgery especially if it is a patient with a long evolution of diabetes and that has already had time to affect the arteries. Any diabetic, smoker, hypertensive and dyslipidemic patient, even without symptoms, should see a specialist for an updated study of the degree of affectation that these risk factors have caused. Prevention is also fundamental in the diabetic foot.
Different treatments according to the stage of the diabetic foot
The diabetic foot (with the presence of skin ulceration) has different phases, so it will also have different treatments depending on the phase in which the diabetic foot is. First of all, the specialist must explore the foot, and if he/she presents a preserved exploration of the great arteries, he/she will treat the cutaneous lesion to prevent it from becoming over-infected and for it to heal as soon as possible. At the same time, the specialist must prevent weight bearing directly on the ulcer, and this is achieved by means of an unloading insole that will be made by the podiatrist.
In more advanced stages of diabetic foot and if the arterial exploration shows lesions in the arteries leading to the foot (femoral, popliteal, anterior and posterior tibial, and peroneal) will treat them by catheterization by endovascular surgery and, if necessary, perform a bypass or By-Pass.