Diabetic Foot Gangrene Treatment

Diabetic Foot Gangrene Treatment - Dr. Hossam El Mahdy

Blood plays an important role in the body to transport oxygen and nutrients and provide the antibodies needed to fight disease. When blood does not circulate freely in the body, its cells do not survive and the condition can develop into tissue death, which is called gangrene.

Gangrene means the death of body tissues as a result of insufficient blood flow to them. Diabetic gangrene is one of the common health problems among people and needs medical intervention to avoid aggravating the situation.

Diabetic foot:
Diabetic foot is one of the most serious complications of diabetics due to sensory neuropathy. Diabetic foot leads to several effects on the feet in terms of foot shape and skin color, and on the body in terms of its ability to perform vital functions.

How does diabetic foot gangrene occur?
Diabetes increases the chances of developing gangrene. Diabetes leads to damage to the sensory and motor nerves and the patient losing the ability to feel the feet; Which makes the patient do not feel the injuries and sores that his feet are exposed to, to become more vulnerable to infection and the spread of bacteria.
Diabetes also affects the functions of the blood vessels, as the blood supply to the feet is reduced, which carries nutrients and oxygen needed to feed the cells and the immune system; This makes the healing of wounds on the feet more slowly.

Symptoms of gangrene include:
- Cold and numbness in the affected area.
- Pain in or outside the affected area.
- Redness and swelling around the wound.
- Persistent ulcers in the same place.
- The body temperature rises above 38.
- Skin discoloration greenish-black, blue or red.
- Pus or discharge from the wound.
- The appearance of blisters and a feeling of crackling under the skin.
- Hypotension to the point of shock, which becomes life-threatening.

Who are the people most susceptible to gangrene?
Gangrene occurs when the blood supply to a part of the body is stopped and the tissues die. Gangrene usually begins in the toes or feet. Gangrene can occur as a result of a serious injury such as a severe cut or burn, an infection or a medical condition that affects circulation and blood flow and increases the risk of gangrene.

Certain groups of people are at higher risk of developing gangrene who have long-term conditions that can affect their blood vessels, such as the following diseases:
It is a lifelong, chronic disease that makes a person's blood glucose level too high.
Peripheral arterial disease:
Which includes atherosclerosis, which is a condition of arterial occlusion due to the accumulation of fatty substances and cholesterol on the wall of the blood vessel, narrowing it and restricting blood flow to it.
Raynaud's disease:
Blood vessels react abnormally to cold temperatures and stress in certain parts of the body, usually the toes, narrowing small arteries and impeding blood supply to the limbs.

Types of gangrene:
Dry gangrene:
It is most common among diabetics, and immune diseases and appears in the limbs area that begins in red and turns black.
Wet gangrene:
It occurs as a result of infection in wounds and ulcers in parallel with the lack of blood flow to the affected area; This causes tissue death. This makes the area swollen, pus and smelly, and it can also spread to other parts of the body.
Gas gangrene:
It is one of the types of wet gangrene and is considered the most dangerous because it affects the internal organs of the body, where bacteria secrete toxins in the absence of oxygen and destroy the affected organ.

What are the complications of gangrene?
Because gangrene can spread quickly over a large area of ​​the body, the amount of dead tissue can be quite large. Untreated large areas may result in large areas of scars, and severe gangrene may result in death due to the rapid spread of bacteria to the rest of the body.

When do you need to visit a vascular surgeon?
Gangrene is a medical emergency. The case of gangrene depends on the area and size of the affected area, in addition to other diseases that the patient suffers from. Gangrene is often life-threatening; Therefore, immediate medical care is very important and you should visit the best doctor in vascular surgery, Dr. Hossam El-Mahdy, Professor of Vascular Surgery and Diabetic Foot Treatment at Cairo University, when the following symptoms appear:
- Persistent fever.
- Pale skin and a feeling of coldness in the feet.
- Constant changes in the shape, color and temperature of the skin.
- Foul-smelling discharge from the sore.
- Feeling of pain and numbness in the feet.

What are the methods of diagnosis of diabetic foot gangrene?
Several medical examinations and tests are performed to assess the condition, including the following:
- Perform a physical exam to check for signs of tissue death.
- Conducting blood tests to detect the number of white blood cells and if they are in the normal range or not, as their presence in higher than normal rates is evidence of infection.
- Performing the necessary x-rays to determine the condition of the arteries and the rate of blood flow in them.
- Examine samples of tissue or fluid from the affected area in the laboratory.

How are different gangrene cases treated?
Prof. Dr. Hossam El-Mahdy determines the best treatment plan for the patient based on his or her age, general health, medical history, disease severity and prognosis. A gangrene treatment plan usually consists of one or more of the following:

Taking antibiotics: These drugs can be used to kill bacteria in the affected area, so they are used in cases of wet gangrene.

Surgical removal of dead tissue: This procedure aims to prevent gangrene from spreading to nearby healthy tissue, and a skin graft may be recommended to create a suitable environment for wound healing. In cases where gangrene has spread, a toe or even a limb may need to be amputated.

Hyperbaric oxygen therapy: During this procedure, the patient is placed in a special room equipped with hyperbaric oxygen, which pushes more oxygen into the affected area. This can promote quick healing and help kill bacteria. This treatment is especially effective in people who develop gangrene from diabetic foot ulcers.

Therapeutic peripheral catheterization: If gangrene is caused by poor blood flow, therapeutic peripheral catheterization may be recommended to improve circulation.

Treatment of gangrene by therapeutic peripheral catheter:
When visiting a vascular surgeon at the beginning of gangrene, treatment is possible without going for amputation, through the treatment of circulatory failure that causes a lack of blood flow.
Therapeutic peripheral catheters dilates blocked or narrowed arteries through the use of a therapeutic balloon and stents if necessary, as well as cleaning already damaged tissue.

How can gangrene be prevented?
You can help in preventing gangrene by doing the following:
- Carefully monitoring any wounds you have.
- Getting immediate attention if signs of infection appear.
- Carefully following the treatment plan prescribed to you if you have certain conditions that can affect your circulation such as diabetes and peripheral vascular disease.