Diabetic Foot Treatment in Surat

Diabetic sores on the feet usually appear over a bony point, such as the ball of the foot, the tip of a toe or the heel. The orthopaedic contribution is to take pressure off the sore, using a total contact cast, a removable walker, or a customised insole and footwear. A cast that cannot be removed is the more reliable choice, because removable devices only help when they are worn. Wound dressing, removal of dead tissue and antibiotics where infection is present go on alongside this.

Every foot ulcer needs the blood flow and any sign of infection checked at the first visit, and an X-ray or MRI looks for infection in the bone. Any new foot sore should be seen within a day. A sore that is not clearly smaller after about four weeks of proper care needs a full re-assessment.

Surgery is not the first step. It is considered for:

• infected or dead bone and soft tissue that needs to be removed;
• a bony prominence that keeps causing the same ulcer;
• a tight calf or Achilles tendon that overloads the front of the foot;
• an unstable Charcot deformity that cannot be managed with a brace or footwear.

Tissue that has died, called gangrene, from loss of blood supply or severe infection, needs urgent hospital assessment. Where blood flow is the problem, a vascular surgeon's opinion comes first. Dr. Khanna usually does the orthopaedic part himself: removal of infected or dead tissue, Charcot reconstruction and, when infection cannot otherwise be controlled, partial foot amputation, with the level chosen to keep a foot that can bear weight and fit footwear. Surgery in people with diabetes carries a higher risk of wound problems, so sugar control, kidney function and circulation are checked first.

• Look at both feet every day, including the soles and between the toes. Use a mirror or ask a family member.
• Do not walk barefoot, even at home, and check inside shoes for stones or rough seams.
• Do not cut corns or calluses yourself, and avoid hot water bottles or heating pads on the feet.