David G. Armstrong, D.P.M., M.D., Ph.D.
Professor of Surgery, Keck School of Medicine, University of Southern California
People with diabetes lose what we call “the gift of pain.” They can’t feel injuries due to nerve damage caused by their diabetes. Diabetic foot wounds, when left untreated, can lead to amputation, and amputations decrease both quality of life and your ability to stay active, threatening a patient’s quality of life.
Prevention is key
Of course, prevention is the best course of action, and prevention is all about timing. A simple daily foot exam can identify minor injuries, sores, blisters or other changes before they become serious problems. Make that exam part of your routine, like combing your hair or brushing your teeth. You should also have an annual foot exam with your podiatrist, just like you have an annual eye exam.
If you do experience a foot wound of any kind, you need to see your podiatrist immediately. The longer you wait, the higher the odds that this wound will result in amputation. A podiatrist will evaluate the wound for size, depth, and location. Your physician will also assess the blood flow to your feet. If your feet aren’t getting adequate blood flow, the tissue is not getting enough oxygen and won’t heal well. Your podiatrist may refer you to see a vascular surgeon or other specialist. We’ll also address any infection before we administer further care. Other members of the team may also be called in for care at this point. Remember, health care is a team sport, and you’re team captain.
The path to healing
Once we’re confident your feet have proper blood flow and we’ve controlled the infection, we begin the work of healing the wound. It’s not what you put on the wound that heals it; it’s what you take off the wound. We take off any pressure you may be putting on the wound with special kinds of bracing, and we take off what is not viable. The best surgery is the one we never have to do. But if we do have to remove some dead tissue to spare your limb, we will do so.
The greatest call to action I can make is to implore you to check your feet daily, and get that annual foot exam. When a podiatrist is able to deliver timely care, studies have shown we can dramatically decrease amputation and even hospitalizations.That’s good news for our health care system and great news for you and your family. Together, we can save limbs and lives.
