In the Podiatric Pathology and Surgery Unit of the Paracelso Clinic we are specialists in addressing complex foot problems, such as the correction of deformities, the sequelae of accidents or foot complications resulting from diabetes, popularly known as diabetic foot.
Dimension of the problem
The annual incidence of foot ulcers in diabetic patients is 2-3%, with a prevalence of 2-10%. In addition, 15% of patients who develop an ulcer will eventually undergo amputation.
On the other hand, in 65% of cases, the pathogenic sequence leading to the appearance of the ulcer is constituted by several factors such as:
- Presence of neuropathy, i.e., absence or sensory decrease.
- Deformation of the foot with areas of hyperpressure due to overloads and trauma through blows, use of inadequate footwear, etc.
Therefore, it is safe to say that ulceration is quite preventable if appropriate measures are taken. The identification of patients at risk, their education, the use of insoles when necessary and a multidisciplinary care for the diabetic foot, can be effective strategies to reduce by up to 50% the cases of amputation.
Therefore, both the prevention and treatment of diabetic foot, which are carried out at the Clínica Recoletas Paracelso are aimed at:
- The screening and identification of controlled diabetic patients with a higher risk of foot ulcers.
- The instruction and care of patients at higher risk.
- The protocolization of the treatment of infected and non-infected diabetic foot.
- Reduction in the number of ulcers and amputations.
- Collaboration with Primary Care and other specialties to care for patients at higher risk referred to us.
Preventing diabetic foot
Simple tests determine the patient’s risk of ulceration. These tests check if there is a reduction in sensitivity with which the patient can not really perceive a lesion that can be complicated.
In addition, it should not be forgotten that the appearance of an ulcer usually comes from a callus that is complicated as shown in the following image.
It is of vital importance that patients know the state of their diabetes, as well as the risk they have of suffering any inconvenience due to their disease. Based on the results of these tests, the possible risk of ulceration is detected and also the assiduity with which the patient will have to visit the doctor for regular check-ups.
Treatment of diabetic foot
In our unit we treat neuropathic ulcers, making a diagnosis and referring them to vascular surgery if necessary.
When the patient presents a foot lesion with acceptable arterial perfusion, we take care of treatment to stop its evolution, since it can be a serious problem if not treated promptly. In cases where the infection is not stopped in time, there could be an extreme risk of amputation.
For this reason, it is important that patients go for consultation when they have the slightest suspicion of a foot problem.
The most common treatments performed at the center are:
- Tailored offloading so that the ulcer is not subjected to pressure and can heal.
- Debridement and topical cures of the lesions.
- Cure of the infection.
- Surgery when necessary.
- Multidisciplinary approach.
- Templates to minimize possible recurrences.