THE DIABETIC FOOT: A SURGICAL PERSPECTIVE. Dr.Ajit Kumar Varma, M.S. Senior Consultant, Diabetic lower limb and Foot & ankle reconstructive surgeon.
WHY MAJOR LOWER LIMB AMPUTATION SHOULD BE PREVENTED IN A DIABETIC PATIENT. Every 30 seconds a leg is still lost because of diabetes, somewhere in the world.
Let us review some of the incorrect practices in India, leading to foot injuries.
BARE-FOOT WALKING Never walk barefoot. It can cause foot problems. Always use prescription Diabetic foot wear.
Rat-bite Injury & Ant bite injuries
Self Surgery, A Dangerous Practice.
Extensive Necrotizing Fasciitis of the leg:--- Most of these patients are very sick, some requiring ICU care
Necrotizing Fasciitis of the Foot:---Requires urgent debridement & supportive management.
“OFFLOADING” the diabetic foot for any foot or lower limb problems is VITAL in the management. “More than what you put on the wound, it is what you take “ OFF ”from it, that is important. ”
10 commandments of the diabetic foot care: I am thy foot forever. Take good care of me, for thou shalt have no foot other than me. Thou shalt regularly debride me, when I develop callosities and ulcers. Thou shalt fit me with casts and insoles to offload my high pressure areas. Thou shalt carefully look for early signs of infection in me and treat it aggressively.
5.Thou shalt diagnose ischaemia without delay andrevasularise me. 6.Thou shalt educate all patients how to examine me and takecare of me. 7.Thou shalt carefully inspect the shoes that I have to wear and encourage the use of appropriate footwear. 8.Thou shalt continuously aim to achieve tighter blood glucose control for me. 9.Thou shalt not commit amputation on me, unless there is a compelling reason. 10.Thou shalt try to improve upon your lower limb salvage methods.
INVESTIGATIONS:tcpo2(microcirculation) Pedopodogram Plantar pressure measurements Negative Pressure Wound Therapy AnodyneTherapy For Neuropathy
REVASCULARISATION PROCEDURES ANGIOPLASTY PERIPHERAL BYPASS
Reconstruction: • Compression screws • On-lay plates • Rush nails • Staples
PRE-OPERATIVE POST-OPERATIVE Mid and Hind foot Arthrodhesis— Stabilized by the ‘SLING TECHNIQUE’
Hallus Valgus Corrective surgery. Pre-operative Post-operative.
Prosthesis for destroyed proximal phalynx, Great Toe. Triplearthrodhesis
PMMA replacement prosthesis for completely destroyed mid and hind foot bones.
AMPUTATION PREVENTION is our motto. COMPREHENSIVE TEAM APPROACH HAS HELPED US TO ACHIEVE EXCELLENT FOOT SALVAGE RATE EQUAVALANT TO THE BEST CENTERS IN THE WORLD.
CONTACT DETAILS: House Address : Dr.Ajit Kumar Varma AMRITAKRIPA, 49/524-H, KALPAKA VILLAS, PARAYIL ROAD, PUTHUKKALAVATTOM, PUNNAKKAL, ELAMAKKARA P.O, KOCHI 682 026. KERALA. INDIA. E Mail firstname.lastname@example.org Official Address: Dr.Ajit Kumar Varma Senior Consultant. Department of Podiatric Surgery. Aster Medcity Hospital, Kuttisahib Rd, South Chittoor, Kochi--682027. Kerala, India. Email: email@example.com Phone: 91 484 6699999