Foot ulcers are a common complication of peripheral arterial disease and a major cause of disability of patients. It is worse when associated with diabetes. Ischemic and diabetic foot ulcers lead to amputation if not managed properly.

1. FOOT CARE AND ULCER MANAGEMENT
AT VASCULOCARE: OUR AIM TO
SALVAGE FOOT.
DR. SHANTONU KUMAR GHOSH
MS (CVTS)
VASCULAR, ENDOVASCULAR & LASER SPECIALIST SURGEON

2. Foot ulcers are a common
complication of peripheral
arterial disease and a major
cause of disability of
patients. It is worse when
associated with diabetes.
Ischemic and diabetic foot ulcers lead to
amputation if not managed properly.

3. Diabetic ulcer results from
microangiopathy and
neuropathy. Sensory loss and
lack of blood supply lead to
biochemical abnormalities,
dryness of skin due to
decreased sweating, all lead
to vulnerability of skin and
ultimately ulceration.

4. Reduced oxygen and nutrition supply to ulcer area
hampers ulcer healing. This makes a favorable
environment for bacterial growth and ultimately leads
to necrosis of tissue. In chronic cases ulcer involve
bone leading to osteomyelitis.

5. Amputation leads to disability of patient
and grossly hampers quality of life.

6. Our aim at
Vasculocare is to
prevent or minimize
level of amputation
and reduce the
disease burden.

7. If there is any ulcer with discharge, we first do the culture
and sensitivity test and use antibiotic accordingly.

9. Primary goal: Revascularization
Surgical-
Aorto iliac bypass
Ilio-femoral bypass
Femoro-popliteal bypass
Femoro-distal bypass
Endovascular- ?

10. Primary goal: Revascularization
Extensive medical management-
Prostaglandin E1

11. Limb care:
Moisturization- Coconut oil
Prevent dependent oedema
Management of skin disease

12. Care of ulcer:
Dressing with betadine/ eusol/ H2O2
Wound debridement
Application of platelet rich plasma

13. Use of special dressing material
Recombinant Human PDGF 0.01%
Silver Gel 0.002%

14. Current study:
Collagen Gel

15. Common amputations for foot:
Selective amputation of toes/ foot
Partial amputation of toes
Total amputation of toes
Ray amputation
Sims amputation
Disarticulation

17. Rehabilitation/ life style modification
Sole
Shoes
Phosthetic limb

18. Diabetic footwear

19. Prosthetic limb

20. At Vasculocare we apply all these techniques
to prevent limb loss or at least reduce the
level of amputation with the target to reduce
morbidity of patient. Post operative foot care,
life style modification and control of diabetes
is essential to maintain the successful result.

21. Dr. Shantonu Kumar Ghosh
MBBS, MS (CVTS)
Vascular, Endovascular and Laser Specialist Surgeon
Vasculocare
Trauma Center, 22/8/A, Shyamoli, Dhaka, Bangladesh
Secretary for International Affairs, Bangladesh Vascular Society
Treasurer, SAARC Society of Vascular Surgery
President of Bangladesh Chapter, World Young Experts Committee of IUA
Contact- +8801715405567
Corresponding Member- ESVS, Life Member- VSI, VAI
E-mail- shantonukumarghosh@gmail.com
Website- www.vasculocare.com
Facebook- www.facebook.com/vasculocare