Diabetic foot is an ulceration of the tissues of the foot in patients with diabetes mellitus. It derives in ulceration when it has not been treated correctly in an early way, so it is important to monitor the feet in diabetic patients. Plastic surgery can address it both preventively and to treat the complications of the disease.
Causes and affectations of the diabetic foot
The causes of the appearance of ulcers in the feet of the diabetic patient or diabetic foot is the injury of the nerves, called diabetic neuropathy. The nerves are affected in its 3 components:
- Sensitive: it produces alterations in the sensitivity of the foot, leaving it unprotected and making it more loaded and unaware of the presence of foreign bodies in the footwear or the friction produced by it.
- Motor: produces alterations in the way of plantar support, losing the normal way of walking.
- Autonomic: responsible for the appearance of dryness in the foot.
How to prevent the onset of diabetic foot
Daily monitoring of the feet is the most important preventive measure for the development of lesions. In addition, it is necessary to recognize existing deformities in order to treat them before the appearance of ulcers.
What is the contribution of plastic surgery in the treatment of diabetic feet?
There are several ways to apply plastic surgery in the treatment of diabetic foot:
- Preventive facet. The preventive form can perform desiccations of the posterior tibial nerve to improve neuropathy in cases where patients have lost sensitivity. The intervention is simple and consists of opening the tarsal tunnel where the posterior tibial nerve is trapped. The objective is none other than to improve plantar sensitivity.
- Diabetic foot complications. In the rest of the applications of Plastic, Aesthetic and Reconstructive Surgery, diabetic foot complications are treated. It is very important to point out that it is essential to have an adequate medical treatment, the revision by vascular surgery and traumatology before starting any type of reconstruction. This is the reconstruction of foot ulcers to avoid amputations. This requires a good vascular study and to rule out that there is no infection in the bone. When there are healthy vessels and there is no infection in the bone, we can consider reconstruction to avoid amputation.
What does the technique and the postoperative reconstruction for diabetic foot consist of?
To perform the reconstruction, transplants of healthy and well vascularized tissues from other locations of the body (usually the thigh) are performed, which are joined to the arteries and veins of the feet. These are complex microsurgical procedures that last about 5 hours. If the patients are well selected, the surgery is safe. The postoperative period requires an overnight stay in the ICU and then a hospital stay of about 7 days. The patient will then have to walk with insoles or another type of orthosis to improve support. It should be pointed out that without careful care of the operated foot and adequate control of the disease, ulcers will recur in a short period of time.