Diabetic Foot Globally

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About the Global Burden of Foot Problems, especially Diabetic foot

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Diabetic Foot Globally

  1. 1. DR JAYESH KAKAR Consultant Diabetic Foot & Peripheral Vascular Surgeon SAVE LEGS CLINIC TEL : 9966668283 www.savelegs.com Hon Consultant : Mumbai Hon Consultant : Hyderabad Breach Candy Hospital Global Hospitals, BSES MG Hospital Mahavir Hospital
  2. 2. WHY THE NAME ? SAVELEGS.COM
  3. 3. AIMS : After a thorough Clinical, Radiological & Orthotic Evaluation of patients, we aim to achieve the BEST in •LEG CONSERVATION •AMPUTATION PREVENTION •REHABILITATION OF PATIENTS SAVELEGS.COM
  4. 4. THE CLINIC IS DEDICATED TO THE PREVENTION & TREATMENT OF LOWER LIMB DISORDERS TREATMENT INVESTIGATIONS PREVENTIVE CARE & REHABILITATION FOOT AIDS like CUSTOMIZED FOOTWEAR, MEDICAL COMPRESSION STOCKINGS, INSOLES and other STOCKINGS INSOLES, PODIATRIC AIDS Are available for the FIRST time under one ROOF, for , MAXIMUM CARE & CONVENIENCE OF PATIENTS. SAVELEGS.COM
  5. 5. EVEN THOUGH WE TREAT MOST FOOT & LEG PROBLEMS THE FOCUS OF THIS PRESENTATION WILL BE ON SOME OF THE COMMONEST PROBLEMS PICTORIALS, GRAPHICS & TEXT AIM IS TO SPREAD AWARENESS - WITH THE SCIENCE OF LEG SALVAGE & PODIATRY, IT IS TODAY POSSIBLE TO SAVE LIMBS & CURE LEG PROBLEMS THAT A FEW YEARS BACK WERE CONSIDERED EITHER CHRONIC OR INCURABLE SAVELEGS.COM
  6. 6. PODIATRY ( TREATMENT OF FOOT DISORDERS ) SURGICALLY : FOOT MODIFICATION USE OF ORTHOTICS SAVELEGS.COM
  7. 7. ORTHOTICS THE USE OF SPECIFIC DEVICES, CUSTOM MADE TO TREAT/PREVENT VARIOUS PROBLEMS ATTRIBUTABLE TO THE FOOT FOOT. SAVELEGS.COM
  8. 8. Common L & F t Problems C Leg Foot P bl SAVELEGS.COM
  9. 9. DIABETES STATISTICS •6% of Global Mortality •Every 10 Seconds a person dies of Diabetes Related Mortality •Every 10 Seconds 2 People develop Diabetes y p p •Upto 25% of Family Income may go towards Diabetes care in Low Income Indian Families •India has the World’s LARGEST Diabetes population •40 % of admissions of Diabetic Patients are due to FOOT 40 Problems SAVELEGS.COM
  10. 10. Diabetic foot 15% of diabetics experience serious foot p problems. They are the leading cause of hospitalizations y g p for these patients. DIABETES IS THE LEADING CAUSE OF NON TRAUMATIC LOWER LIMB AMPUTATIONS – 50-70% SAVELEGS.COM
  11. 11. 2006 FIGURES SAVELEGS.COM
  12. 12. SAVELEGS.COM
  13. 13. DIABETIC FOOT THIS TERM WOULD NORMALLY EVOKE ONE OF THE FOLLOWING PICTURES : LEADING TO THIS SAVELEGS.COM
  14. 14. IGNORANCE IS BLISS SAVELEGS.COM
  15. 15. Diabetes & Foot Check Up NEUROTHESIOMETER C-W C W DOPPLER To Measure To Detect Nerve Damage Blood Supply to the Feet DIABETICS MUST GET THEIR FEET CHECKED ONCE AN YEAR TO AVOID FOOT COMPLICATIONS *Report of the The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20(7):1183-1197. SAVELEGS.COM
  16. 16. DIAGNOSIS •BURNING/TENDERNESS/NUMBNESS IN THE FEET •LOSS OF BALANCE •SHARP PAINS OR CRAMPS •FEELING OF ‘SOMETHING’ UNDER THE FOOT SAVELEGS.COM
  17. 17. COMMON FOOT PROBLEMS IN DIABETICS •Infection •Pus formation •Ulcerations •Gangrene i the feet of in h f f long standing diabetics. Ulcer- Common SIGHT & Site in Diabetic Patients SAVELEGS.COM
  18. 18. Gangrene Toe Gangrene Heel Gangrene SAVELEGS.COM
  19. 19. Varicose Veins Tender soft knots or winding veins in the calf or leg that are worse after standing for long periods periods. May also present as aching & swollen legs at the end of the day. SAVELEGS.COM
  20. 20. TREATMENT SURGERY MOST PATIENTS WITHOUT COMPLICATIONS CAN BE MANAGED AS DAYCARE OR SHORT TERM(1-2 DAYS) STAY CASES LASER TREATMENT SAVELEGS.COM
  21. 21. Chronic Venous Insufficiency ECZEMA AND SKIN CHANGES A form of eczema can occur in the calf, sometimes over an area of varicosity. The skin is red and itchy. Areas of the calf and around the ankle may develop a b ow stain the s . brown sta in t e skin. SAVELEGS.COM
  22. 22. WHO GETS VENOUS PROBLEMS ? 1. HEREDITARY – 50% 2. PEOPLE STANDING/SITTING AT WORK FOR LONG PERIODS e.g. TEACHERS, NURSES, POLICEMEN, BUS CONDUCTORS etc. WHAT WORSENS IT ? 1. SMOKING 2. OVERWEIGHT SAVELEGS.COM
  23. 23. COMMON SYMPTOMS OF VENOUS PROBLEMS 1.Heaviness or t 1H i tension i th l i in the legs. 2.Swelling or Feeling of swelling ALL SYMPTOMS TEND TO INCREASE IN THE in the legs- especially around the EVENINGS OR AFTER STANDING FOR LONG ankles. PERIODS AND DECREASE WITH LEG 3.Itching or tingling. ELEVATION 4.Burning Sensation in the legs. 5.Cramps. 6.Restless/Tired 6 Restless/Tired legs SAVELEGS.COM
  24. 24. COMPLICATIONS OF VENOUS DISORDERS •HAEMORRHAGE (Bleeding) •THROMBOPHLEBITIS SAVELEGS.COM
  25. 25. SKIN C S CHANGES : - Darkening of the Skin due to G S g PIGMENTATION •VENOUS ULCERS VENOUS SAVELEGS.COM
  26. 26. Peripheral Vascular Disease Arterial Problems Pain i th l P i in the legs on walking (relieved by g( y rest) SAVELEGS.COM
  27. 27. NON HEALING ULCERS IN THE LEG AND FEET More common in diabetics, smokers, the obese or people with a family history of atherosclerotic disease. p p y y SAVELEGS.COM
  28. 28. Heel Spur Presents as a sharp pain in the centre of the heel, heel worse in the morning and begins to lessen as you begin to walk. SAVELEGS.COM
  29. 29. INGROWN TOE NAIL A toenail which appears to be toenail, abnormally shaped and repeatedly keeps getting i f t d and discharging pus or infected d di h i a watery discharge tinged with blood. CORNS & CALLOSITIES Thickened and painful areas of skin. SAVELEGS.COM
  30. 30. FOOT DEFORMITIES SAVELEGS.COM
  31. 31. DEFORMED FOOT DUE TO DIABETES SAVELEGS.COM
  32. 32. BUNION Outward deviation Of the Great Toe HAMMER TOES SAVELEGS.COM
  33. 33. BUNIONS & ULCERS > 5YRS IN A DIABETIC 4 MONTHS AFTER SURGERY SAVELEGS.COM
  34. 34. FOOT ULCER 20 YRS 3 MONTHS AFTER DURATION TREATMENT SAVELEGS.COM
  35. 35. HEEL ULCER WITH 4 MONTHS AFTER PVD WITH SURGERY & WOUND CARE DIABETES > 6-7 YRS SAVELEGS.COM
  36. 36. CVI WITH CELLULITIS WITH ULCERATION 5 MONTHS AFTER SURGERY SAVELEGS.COM
  37. 37. LARGE VENOUS ULCER > 5 YRS 4 MONTHS AFTER SURGERY SAVELEGS.COM
  38. 38. MANAGEMENT • CUSTOMIZED FOOTAIDS (ORTHOTICS) • FOOT MODIFICATION TO PREVENT RECURRENT ULCERATION C C A O SAVELEGS.COM
  39. 39. SAVELEGS.COM
  40. 40. Ischemic ulceration Hair loss Pallor/Cyanosis/Rubor P ll /C i /R b Muscle atrophy p y Smooth, shiny skin, ed skin temperature t t Edema SAVELEGS.COM
  41. 41. VASCULAR BYPASS SURGERY SAVELEGS.COM
  42. 42. SAVELEGS.COM
  43. 43. SAVELEGS.COM
  44. 44. SAVELEGS.COM
  45. 45. SAVELEGS.COM
  46. 46. SAVELEGS.COM
  47. 47. OTHER MODALITIES HBO PROSTAGLANDINS MAGGOT THERAPY HONEY ULTRASOUND ETC HAVE NO WELL DEFINED ROLE BUT MAY BE USED IN SELECTED/RESISTANT CASES AT THE DISCRETION OF THE TREATING PHYSICIAN SAVELEGS.COM
  48. 48. SAVELEGS.COM

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