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Diabetic foot
Diabetic foot VSD (Vacuum Sealing Drainage) nursing key points
If you have diabetic foot, it is necessary to check the condition of your feet every day. When washing your feet daily, observe the color and shape of the feet, whether there is any skin damage, and whether there are changes in local color. Secondly, more professionally, you can feel the pulsation of the dorsal artery of the foot to see if it is normal. Third, insist on washing your feet daily to maintain cleanliness and hygiene. Be careful that the water temperature for soaking should not be too high, preferably not exceeding 40 degrees Celsius, and do not soak for more than 30 minutes. Additionally, trimming nails is very important. Do not tear them with your hands to avoid damaging the skin of your feet; use scissors to cut long nails. Another important aspect is shoe wearing. It is best to wear loose-fitting shoes to avoid rubbing against the feet and breaking the skin.
The precursor of diabetic foot
Diabetic foot is commonly seen in patients who have had diabetes for over ten years, often due to poor blood sugar control and inadequate care. There are three factors that lead to diabetic foot. The first is vascular factors, often accompanied by arterial stenosis in both lower limbs, leading to blood supply disorders. The second is neuropathy, accompanied by peripheral neuropathy, insensitivity to temperature and pain, which makes it easy to suffer burns and external injuries to the foot. The third factor is the presence of an infectious trigger. When these three factors combine, the risk of diabetic foot becomes very high.
How to reduce swelling in diabetic foot
How to reduce swelling in diabetic foot depends on the condition of the swelling. If the swelling is due to a wound on the diabetic foot causing localized redness and swelling, this condition needs anti-infective treatment. It is recommended to culture the wound secretion and choose a sensitive antibiotic; if the swelling is diffuse in the foot, it is also recommended to perform an ultrasound of the lower limb vessels, including arteries and veins. If this indicates poor venous return in the lower limbs or venous thrombosis, treatment to prevent thrombosis and improve venous return should also be added.
How to treat diabetic foot pain
Diabetic foot is a chronic complication of diabetes, characterized by arteriosclerosis, narrowing, and occlusion of the lower limb vessels, and peripheral neuropathy caused by multiple factors following diabetes. Treatment mainly involves improving circulation and nourishing nerves, including performing lower limb arterial ultrasound to assess the extent of vascular occlusion. When necessary, stenting or vascular recanalization can be performed, and treatments including stem cell therapy are also viable options. For pain, severe pain can generally be managed by vasodilation and symptomatic treatment.
Key Points of Diabetic Foot Care
First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes. Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes. Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails. Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries. Fifth, never walk barefoot. Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet. Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth. Eighth, actively control blood sugar levels in diabetes. Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.
Where does diabetic foot hurt?
Diabetic foot refers to those with a history of diabetes who subsequently develop skin ulceration and pus formation on the feet, which can progress to localized gangrene or gangrene of the entire foot. This condition is then termed as diabetic foot. It is usually due to three factors: The first is vascular factors, often accompanied by arterial narrowing in both lower limbs, leading to ischemia and hypoxia. The second is neurological factors, typically accompanied by peripheral neuropathy, causing numbness in both feet and insensitivity to pain, thus often pain is not felt. The third factor involves the presence of an infection. These three factors together make it easy for diabetic foot to develop. Therefore, most patients with diabetic foot do not feel pain. However, if the neuropathy is relatively mild or is a painful neuropathy, these patients may feel pain in their feet or at the site of skin ulceration.
What to eat for diabetic foot
For patients with diabetic foot ulcers, first, their diet should control blood sugar. Foods with a high glycemic index like porridge, glutinous rice, and rice noodle rolls should be avoided. Additionally, sweet foods are also off-limits; it's important for meals to be regular and measured. Second, as patients with diabetic foot ulcers need nutrients for wound healing, they can eat foods high in protein such as eggs, fish, fish soup, and lean meats to promote wound healing. Third, if the patient also has high blood lipids, it's advisable to maintain a light diet and avoid greasy foods.
Care for diabetic foot
The first fundamental step is monitoring blood glucose; good control of blood glucose levels is essential for the effective management of diabetic foot problems. Secondly, attention must be paid to the protection of the wound. It's crucial to keep the wound clean, perform regular cleaning and disinfection, and when necessary, debride necrotic tissue thoroughly. For instance, if there is a sinus tract or deep ulceration, it is essential to open the wound and ensure drainage, removing all necrotic tissue inside. Thirdly, footwear choice is critical for patients with diabetic foot; it is important to wear shoes that are loose fitting, moderately soft yet firm, and capable of evenly distributing pressure across the footbed. There are shoes specially designed for those with diabetic foot, and these can be custom-made. Other considerations include maintaining good blood pressure control and ensuring adequate nutrition to support wound healing, including sufficient protein intake, which plays a vital role in promoting wound repair.
How to deal with diabetic foot ulcers.
For diabetic foot ulcers, the first step is to assess the severity of the foot wound. Treatment definitely requires timely consultation with an endocrinology specialist. The first step is to control blood sugar levels to meet targets; second, control blood pressure and blood lipids; third, administer systemic anti-infection treatment, choosing a sensitive antibiotic based on the wound secretion cultures; fourth, local wound management involves debridement and dressing changes depending on the condition of the wound; fifth, an ultrasound of the lower limb vessels can be conducted to check for arterial sclerosis or occlusion, subsequently using medication to improve circulation.
Can diabetic foot be cured?
Diabetes has many complications, and once detected, the complications of diabetes cannot be completely cured. Diabetic foot is a relatively serious complication of diabetes. Diabetic foot generally involves many years of underlying vascular and nerve damage that eventually leads to infection or ulceration, resulting in the final formation of diabetic foot. Whether such a serious complication can be cured actually depends on the duration of the patient’s condition, the extent of the lesion, and most importantly, how soon they seek medical attention. For instance, if the infection is very severe, has damaged the bone, or if there is dry gangrene with local tissue necrosis in the foot, then no matter what conservative treatment is applied, it will not be effective, and surgical amputation will be the only option, meaning the foot cannot be saved. However, if some individuals only have early-stage skin ulceration that cannot heal, or if there is an infection that is not very severe, and they seek medical attention early, controlling the infection and treating with nerve nutrition and vascular protection can actually heal the ulcerated area of the foot.