Treatment of diabetic foot gangrene in 5 effective steps

Treatment of diabetic foot gangrene

What is diabetic foot gangrene?
Diabetic foot gangrene is a complication of diabetes, which means the death of body tissues as a result of interruption of blood flow to tissues or due to an acute bacterial infection as a result of diabetic foot, and the chance of contamination of wounds with bacteria increases as a result of the presence of wounds without treatment for a long time and the absence of antibodies.

What is the effect of diabetes on the blood vessels and nerves of the feet?
Diabetes can significantly affect the blood vessels and lead to blockage of the arteries of the foot, and the occurrence of circulatory deficiencies, which reduces the adequate blood flow supply to the feet, also high blood glucose levels can affect the small blood vessels that feed the nerves and lead to disturbance of sensation in the feet.

Types of diabetic foot gangrene:
The incidence of gangrene varies from person to person, and the types of gangrene are:
- Dry gangrene: It is the most common type and usually affects the hands and feet, and it occurs when the blood flow is reduced or blocked completely to a specific area, the affected tissue dries up, and its color changes to blue, and then the color turns black.
- Wet gangrene: occurs as a result of infection of body tissues with some types of bacteria, and it can affect any part of the body.
- Gas gangrene: it occurs as a result of a bacterial infection, which leads to the retention of gases and toxins within the tissues, and this type is very dangerous, as it may cause death within 48 hours if not treated.

The symptoms of diabetic foot gangrene:
- Change in the color of the skin to black or red.
- Numbness feeling in the feet.
- Swelling in the affected foot.
- Blisters appear in the affected area.
- Bad odor from the foot ulcer discharge.

How to treat diabetic foot gangrene in 5 steps?
- Removal of dead tissue:
Doctors sometimes have to remove dead tissue to prevent gangrene from spreading and to give the surrounding healthy tissue a chance for treatment and healing.
- Amputation:
In some advanced and critical cases, when gangrene affects a part of the body and continues to spread, the only solution can be amputation, and removal of the affected area such as a toe.
- Treatment of diabetic foot gangrene with antibiotics:
In some cases, diabetic foot gangrene is treated by using antibiotics in the form of injections and tablets.
- Oxygen therapy:
In some cases, gangrene is treated by placing the patient in closed rooms with high pressure and providing an oxygen cover for the face to supply the patient with the oxygen necessary for breathing, then the level of oxygen in the blood is raised and blood flow increases to the affected area, which leads to increase the speed of recovery.
- Treatment of circulatory failure and atherosclerosis: it occurs by using a therapeutic catheter to expand the blocked or narrowed artery with a balloon or a stent.

What is angioplasty surgery?
It is a procedure that is carried out through local anesthesia where a thin tube called a catheter is inserted into an artery in the thigh or arm, and through it, the narrowed area is expanded with a balloon, and sometimes a stent is installed to ensure that the artery remains open, and one of it's most important features is that it does not require general anesthesia, as a local anesthesia is given in the catheter insertion area, so it is suitable for patients who are incompatible for general anesthesia such as cardiac patients, and it's complications are less than the surgery as there is no wound, the patient can return to home after 24 hours, and can be able to return to his normal activities within a few days.

Performing any cleaning of gangrene in the presence of circulatory failure is a common crime in Egypt that leads to the spread of gangrene throughout the foot within a few hours after this wrong procedure.

The causes of diabetic foot gangrene:
The gangrene of the foot or the inner toes is one of the things that disturb the patient when it occurs. Gangrene is the death of tissues and cells due to inadequate blood flow to the foot, as the blood flow works to transport food and oxygen to the tissues of the body in addition to nourishing the immune system and transferring antibodies to fight infection, so the cells begin to die as a result of the death of the tissues of the foot due to the lack of food and oxygen, as the tissues become more susceptible to bacterial infection due to the lack of resistance from the body, and the infection spreads and leads to gangrene.

There are many causes that lead to diabetic foot gangrene such as:
- Having diabetes and high blood pressure.
- Diseases affecting the blood vessels.
- Diseases affecting the immune system.
- Chemotherapy for cancer patients.
- Smoking.
- Obesity.
- Lack of exercise.

Ways to prevent gangrene from occurring:
To prevent gangrene from occurring in the feet, the following instructions are recommended:
- Avoid smoking.
- Full control of diabetes and high pressure.
- Do exercise regularly.
- Maintaining lower blood cholesterol levels.
- Eat a healthy diet that is low in saturated fats, and maintain a healthy weight.
- Maintain your body temperature and avoid exposure to low temperatures.
- Take care of wounds and avoid any infection or inflammation.

How to act when gangrene occurs?
When gangrene occurs, and the color of toe changes to black, you must immediately go to a vascular surgeon, who treats such cases, as the treatment of diabetic foot gangrene varies from case to case and it may reach the point of amputation in critical cases. The vascular surgeon takes your medical history, performs a comprehensive examination of the peripheral blood vessels, with the necessary analysis and examinations, works with the colorful doppler on the leg arteries, and makes a CT scan of the arteries of the leg to know the area and length of the blockage and to see the dead tissue in the leg.

When does the patient need to visit the doctor?
Treating diabetic foot gangrene in the early stages of the disease leads to better results. Therefore, neglecting to visit a doctor when symptoms appear makes treatment difficult,  as delaying recovery leads to worsening the disease, so it is necessary to go to the doctor early if one of the following symptoms appears for diagnosis and start treatment to avoid any complications of diabetic foot gangrene:
- Skin pallor and discoloration.
- Pus and awful odor discharge from the affected areas of the feet.
- Feeling of coldness and numbness in the feet, and loss of feeling in them.
- Having a fever.
- Swelling in the feet.

Contact Dr. Waleed El-Daly, Assistant Professor of Vascular Surgery and Diabetic Foot Treatment at Cairo University, and he is the best vascular surgeon in Egypt now, as he uses the latest medical standards for the treatment of diabetic foot and diabetic foot gangrene, as he used the latest medical standards to save the foot from amputation, and help you to recover faster without any surgical interventions.