People with diabetes have the highest rate of major amputation of any group. Most people know someone who has had this unfortunate experience.
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Diabetic ulcers are a serious complication of diabetes. They can cause ongoing problems with the skin, and if untreated can deepen to affect the underlying bone.
Early treatment is essential to prevent infection and widespread damage to the foot/leg. If left untreated diabetic ulcers can lead to septicaemia and/or loss of the foot or leg.
“Diabetic ulcers refer to breakdown of skin on the lower limbs and feet of people with diabetes,” said Dr Nguyen and Dr Villalba of the Vascular Care Centre. “These are slow to heal and often will not heal at all without treatment.
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“All people with diabetes are at risk of developing diabetic ulcers. The longer a person has had the disease and the higher their sugar levels, the more at risk they become.”
Diabetes can act in three ways to increase the risk of diabetic ulcers:
- It causes blockages in small vessels of the foot and larger vessels in the calf, which decreases the blood supply to the area of damage.
- It can cause damage to the nerves in the foot, altering sensation which leads to small areas of damage being undetected (e.g. blisters from poorly fitting shoes).
- It makes people more prone to infection due to changes in the immune system and higher sugar levels in the tissues.
The best way to avoid diabetic ulcers is to engage a multidisciplinary team of health professionals (GP, podiatrist, dietician, endocrinologist, diabetes educator) to ensure optimal control of blood sugars and early detection of any problems.
Revascularisation is done to restore the blood supply to the foot and leg.
Traditionally this was done with open surgery, using a vein or synthetic graft to pass around the blockage/narrowing in the blood vessel.
Today, the most common way to revascularise a leg affected by diabetic ulcers is to use endovascular techniques.
This involves a needle puncture in the groin, which enables a wire to be passed into the affected artery. The wire can pass through the blockage and a balloon or stent is used to open the artery and allow blood to flow freely again.
This technique can be used in vessels from the upper leg, right down to the foot. The improved blood supply gives diabetic ulcers the best chance of healing.
The advanced surgical technique allows more legs to be saved and gives people a much better quality of life. Phone 4211 0400 for more information.
