Miscellaneous

Diabetic foot, photo initial stage, treatment and symptoms

click fraud protection
Diabetic foot - a complication, the impetus for the development of which is a set of diseases, developing diabetes mellitus. In 90% of the diabetic foot is manifested in patients with type 2 diabetes who suffer from diabetes for 15 to 20 years.

Due to the fact that in diabetes patient tissue, and then the lower limbs begin to lose their sensitivity, any wound, cracks in the skin, burn household, are invisible. In such wounds, infection occurs that affects more skin, muscle and bone and as a result - developing diabetic foot.

How is the SDS

Pathogenesis of diabetic foot formation due to three main reasons:

  • Lesion of blood vessels of the lower limbs;
  • Diabetic neuropathy - the most common complication of diabetes;
  • Infection, which is usually always accompanied by the first two factors.

Prevalence of certain disorders: whether clinical neuropathy, or by changes peripheral blood flow, diabetic foot determines the symptoms that are 3 forms of pathological process. Thus isolated:

  1. Neuropathic embodiment, which is characterized by lesions of the nervous system, both somatic and autonomic. Classification of neuropathy in diabetes is quite extensive, but the main driving force behind the development of SDS is considered to be a decrease of nerve conduction pulses in sensory and motor peripheral nerves, as well as all kinds of sensitivity violation (vibration, tactile, thermal). Neuropathy as a symptom of diabetic foot can flow under three scenarios: diabetic foot ulcers, the formation of the joint osteoarthropathy Charcot neuropathic edema.
    insta story viewer
  2. Neuroischemic or in mixed form, comprising the features and neuropathy, and ischemic lesions due to pathological processes that affect the nervous system and vascular turnpike direction.
  3. Ischemic species evolving due to atherosclerotic changes in vessel walls arterial leg and leads to disruption of the main blood flow.

Isolated form, in particular neuropathic and ischemic, less common, except that at the beginning of the process. Typically, over time formed a mixed form: if SDS triggers ischemia, it is not without the participation of the nerves, and on the contrary - neuropathy, sooner or later attract the participation of the vessels, which in diabetics is very fast and frequently affected atherosclerosis.

Symptoms of diabetic foot

Diabetics are required to monitor the status of the stop and alert to the initial stage of diabetic foot. Numbness, tingling, burning, shifty "goose bumps" - the harbingers of patolgii.

Symptoms of diabetic foot syndrome which needs to pay attention and immediately consult a doctor:

  • skin lesions that do not heal for a long time, fester;
  • skin lesions and nail fungal infection;
  • ingrown nail plate into the skin;
  • change in nail color or darkening;
  • calluses, skin irritation from shoes, corns;
  • cracks in the skin heels, weeping eczema between the fingers;
  • foot deformation (curvature of the fingers, increasing the bone on the thumb).

What is the diabetic foot, photos

The photo shows how the disease is manifested on the legs and in the initial running stages.

complications

Diabetic foot can be complicated:

  1. Necrosis (withering away) of tissues - cause necrosis is generally spread pyogenic infection, however, contribute to the development of this complication may circulatory disorders of innervation and tissues.
  2. Ulceration - their depth and severity of the soft tissue lesion can vary within wide limits.
  3. Pathological fractures - pathological fracture occurs as a result of disruption of normal bone strength, when exposed to stress, usually do not lead to any damage.
  4. Foot deformities - flexion contracture of the fingers (the fingers are fixed in a bent, contorted position), muscular atrophy (decrease in muscle size and strength), the deformation of the arch cushioning it with violation function.
  5. Osteomyelitis - purulent necrotic lesion of bone, is caused by infection of the existing ulcers.
  6. Sepsis - a life-threatening condition that develops when the penetration pyogenic micro-organisms and their toxins in the bloodstream.

Treatment of diabetic foot

In the case of treatment of diabetic foot must be complex, including not only eliminating the clinical manifestations by affected limb, but correction of underlying disease that caused the development of this complication (i.e., the treatment of diabetes diabetes).

Treatment of neuropathic form of diabetic foot include:

  • normalization of blood sugar;
  • ensuring the foot rest;
  • surgical removal of all dead tissue in the wound area;
  • antibiotics in the form of tablets or injections;
  • the use of modern dressings.

Treatment of ischemic form of diabetic foot include:

  • normalization of sugar and cholesterol in the blood;
  • to give up smoking;
  • treatment of hypertension;
  • excessive reduction in blood viscosity (aspirin, heparin);
  • surgical repair of vascular patency;
  • antibiotics

Amputation is also a way of treating diabetic foot syndrome. Indications for amputation - is purulent fusion of the bones of the foot, the critical reduction of blood supply to the tissues.

In Russia, most often performed high amputation. Operation in the middle or upper thigh level is one of the most common. After these interventions the patient is considered invalid. Take care of themselves at home, much less fully work becomes extremely difficult. Therefore, in the first place in dealing with a diabetic foot syndrome comes prevention.

New treatments

The world is constantly investigating new methods of treatment of diabetic foot syndrome. The main objectives of research is to provide more efficient and rapid methods of wound healing, which appear as a result of disease. New methods greatly reduce the need for amputation of limbs, which is so high in this disease.

In Germany, we have already been studied and put into practice a number of methods of treatment of the diabetic foot. On the basis of various clinical trials and testing of new methods of treatment assessed by the medical community as the world very promising.

These include:

  • Method of extracorporeal shock wave therapy;
  • Treatment with growth factors;
  • The treatment with the application of stem cells;
  • Therapy by the plasma jet;
  • Bio-mechanical method;

How to avoid surgery for "diabetic foot"?

Unfortunately, resorted to amputation in about 15-20% of cases of the syndrome of "diabetic foot". Although in most cases, amputation can be prevented by early treatment and correctly.

Primarily, it is necessary to carry out prevention of the formation of venous ulcers. If damage still occurred, treatment should begin as soon as possible. Kindly ask your endocrinologist about the work of specialized rooms Diabetic Foot and contact them in case of problems. High risk of amputation are states such as osteomyelitis (bone suppuration) and ulcer amid critical limb ischemia (severely impaired blood flow to the foot).

Osteomyelitis alternative amputation may be long (1,5-2 months) course of antibiotics, the need to use higher doses and combinations of drugs. At a critical ischemia most effective use poluhirurgicheskogo - balloon angioplasty and surgery - vascular bypass techniques.

Orthopedic shoes for diabetic foot

Wearing special orthopedic shoes is one of the main stages of the prevention and treatment of diabetic foot. The reason is that the conventional footwear is made for healthy people who have not broken blood flow and / or innervation of the feet and legs. Wearing the same shoes the patient with diabetic foot can cause a more rapid development of ulcers.

The main characteristics of orthopedic shoes are:

  1. Patient compliance foot. When buying ordinary shoes can be difficult to directly select the desired size. In addition, due to the structural features of the foot new shoes can "rub" go "push" in the Achilles tendon, ankle, thumb. Patients with diabetic foot such things are not allowed, so are manufactured for these shoes should fit perfectly in all forms and foot deformities.
  2. The absence of irregularities on the inner surface of the shoe. On the inner surface of a shoe or sneaker may have seams or other protrusions tissue defects which may injure the skin of the patient with diabetic foot. It is for this reason that the inner surface of orthopedic shoes must be perfectly flat and smooth.
  3. Rocker soles. Under normal conditions, while walking the load is distributed alternately on the heel and on the foot, the arch of the foot muscles are utilized, reducing the burden on the individual parts. In diabetic foot muscles typically affected data, whereby the middle part of the foot (normally curved upward) is rectified and loses its cushioning properties. Rocker outsole is a rigid plate, the inner (facing the foot) of which is flat (Usually fitted to the shape of the patient's foot), and has a slightly rounded outer surface and a raised sock. As a result, during walking the foot of the patient "rolls" from heel to the front portion, the load on it is reduced by several times.
  4. The lack of a hard toe. In virtually all ordinary shoes the upper part of the sock is made of rigid material, which is bent during walking, and puts pressure on the top of the fingers or toes. In some cases this can lead to calluses or even painful sensations healthy person, in patients with diabetic foot these shoes will certainly be a cause ulceration. That is why the front upper part of the orthopedic shoes are always made from soft materials.

Orthopedic shoes manufactured individually in each case, only after the measurement and evaluation of the foot of the patient parameters.

LFK

Diabetic foot can be performed:

  1. Exercise 1. Starting position - sitting on a chair, his legs are lowered and brought together. Alternately bend and unbend fingers stop 5 - 10 times beginning on one foot and then the other.
  2. Exercise 2. Starting position is the same. You should first raise thumbs up for 5 - 10 seconds, keeping the heel pressed to the floor. Then the fingers must be lowered, and a heel lift up (also 5 - 10 seconds). Repeat the exercise 3 - 5 times.
  3. Exercise 3. Starting position is the same. To raise one foot to 5 - 10 cm above the floor and start to perform a circular movement of the foot, first in one direction (3 - 5 times) and then in the other. Repeat the exercise with the other leg.
  4. Exercise 4. Starting position is the same. You should first straighten one leg at the knee, then bend it in the ankle, trying to pull his fingers as low as possible. Hold the leg in a position 5 - 10 seconds, and then lower it and repeat the exercise with the second leg.
  5. Exercise 5. Starting position is the same. Straighten the leg at the knee, then straighten it in the ankle while trying to reach the fingers to the toes. Repeat the exercise with the other leg.

Exercise therapy (therapy) and special exercises may have some positive effect in the diabetic foot. The goal of exercise in this case is to improve the blood supply to the ischemic tissue of the lower limb. However, it is worth remembering that in the ischemic form of the disease lesion mechanism is blockage of the blood vessels, that supply blood to the tissues, so excessively large loads can lead to increased pain and Development complications. That's why once it is necessary to exclude any exercises and activities related to the increase in the load of the foot (Walking, running, cycling, weight lifting, prolonged exposure in the "standing" position, and so Further).

Caring for diabetes feet

Prevent the development of diabetic foot is much better than cure. Diabetes - a disease of chronic, so good care of your feet should enter into a daily habit. There are some simple rules that will significantly reduce the frequency of occurrence of venous ulcers.

The main problem for diabetics is the selection of shoes. Due to the decrease in tactile sensitivity, patients over the years are tight, uncomfortable shoes, causing irreversible damage to the skin. There are clear criteria that a person with diabetes should choose shoes.

  1. Consult your doctor in the event of even a minor inflammation. Even a slight inflammation can lead to serious consequences.
  2. Each day, inspect the legs to reveal cuts, scrapes, blisters, cracks and other damage, through which the infection is able to penetrate. The underside can be viewed by means of a mirror. If poor vision is better to ask to do it someone from the family members.
  3. Wash your feet every day is necessary, wipe gently, without rubbing. We can not forget about the interdigital spaces - they also need to be thoroughly washed and dried.
  4. Inspect shoes daily to prevent calluses and other damage, which can result in foreign objects into the shoe insole wrinkled, torn lining, etc.
  5. Do not expose your leg action is very low or very high temperatures. If feet are cold, it is better to wear socks, you can not use heaters. The water in the bathroom, you must first check out a hand and make sure it is not too hot.
  6. Shoes should be as convenient, well sit on the leg, you can not buy shoes, you want to break in. With significant foot deformities require specially made orthopedic shoes. Street shoes can not be worn on bare feet, sandals or sandals, in which the strap is held between the fingers, are contraindicated. Do not walk barefoot, especially on hot surfaces.
  7. Socks or stockings to change every day, wearing only suitable in size, avoid tight gums and darned socks.
  8. Can not injure the skin of the feet. Do not use drugs and chemicals, softening calluses, removing calluses with a razor, scalpel and other cutting tools. It is better to use a pumice stone or a file for the feet.
  9. For injuries contraindicated iodine, alcohol, 'potassium permanganate, "" brilliant green "- they have tanning properties. Better process abrasions, cuts, special means - miramistin, chlorhexidine, dioxidine, at most, 3% solution of hydrogen peroxide and apply a sterile dressing.
  10. When dry skin legs you must lubricate fat cream every day (with the content of sea buckthorn, peach oil), but interdigital spaces can not be lubricated. It is also possible to use a cream containing urea (Balzamed, Kallyuzan etc.)
  11. Trim the nails just right, not rounded corners. Thickened nails are not cut and rasp. If sight is poor, better to take the help of family members.
  12. Stop smoking, smoking can increase the risk of amputation in 2.5 times.

Folk remedies

In the early stages of diabetic foot treatment, you can use the following popular recipes:

  1. To make lotions on ulcers and washing should pour 1-2 tbsp. l. yarrow herb cup boiling water and leave on a small heat for 5 minutes. Strain using a gauze.
  2. Make the washing ulcers and compresses using broth bird cherry fruits. To do this, pour 4 tablespoons cooking. l. fruit 500 ml of boiling water and hold 15 minutes in a water bath. Strain and cool.
  3. The aqueous extract of red clover is useful for lotions. To cook 2 tablespoons. l. flower placed in a thermos and pour boiling water. After 2 chasa strain.
  4. For particularly hardhealed ulcers suit tincture centaury, for the preparation of grass which to pour boiling water in a ratio of 1 to 10 infusions and leave for several hours.
  5. In use as a disinfectant horsetail preparing broth: 1 tbsp. l. grass pour a glass of boiling water and put on a small fire for 10 minutes.
  6. For the treatment of wounds suit calamus root from which prepare the infusion: 3 tbsp. l. herbs pour 700 ml of boiling water and kept on a water bath for 10 minutes. Insist about a half hour and filter.
  7. Wounds can be treated nettle juice or aloe previously applying it to the tampon or the napkin.

In the treatment of diabetic foot bath will also help, and are particularly useful honey. For their cooking 2 tbsp. l. honey is dissolved in 1 liter lukewarm water. These trays can be taken every day, dipping his feet for 15 minutes.

Forecast

The development of diabetic foot (and even more so gangrene) is very dangerous for human health. Simple principles of prevention, timely conducted by patients, in many cases avoid the appearance of diabetic ulcers. Diabetes and its consequences, such as diabetic foot - the main cause of leg amputations.

  • Share
Moxonidine. Indications for use and contraindications
Miscellaneous

Moxonidine. Indications for use and contraindications

ContentIndications for useArterial hypertensionContraindicationsComponent sensitivitySick sinus syndromeSevere bradycardiaAtrioventricular block 2 ...

Hot flashes in women. Symptoms and treatment in 50+ years
Miscellaneous

Hot flashes in women. Symptoms and treatment in 50+ years

ContentWhat are hot flashes and how do they flowCauses of hot flashes in women over 50ClimaxPanic attacksDiabetesThyroid pathologyPostcastration sy...

Saggy breasts: how to tighten, prevent sagging breasts in women
Miscellaneous

Saggy breasts: how to tighten, prevent sagging breasts in women

ContentHow do you know if your breasts are saggy?Reasons for sagging breastsThe degree of ptosis1 degree of ptosis2 degree of ptosisGrade 3 ptosisW...