DIABETIC WOUND MANAGEMENT


Diabetic Wound Risks
Amputation
Social Costs of Amputation

    DIABETIC WOUND RISKS

    Diabetic patients are at a greater risk for getting infections and have a more difficult time fighting them off. Three known reasons include:

  1. The blood vessels may be damaged so that the blood cannot deliver the needed nutrients, including oxygen, to the body tissues. Peripheral (usually legs) vascular disease means the tissues cannot heal properly. This increases the chances of infection. Diabetics also have increased major arterial disease, which accounts for their greater incidence of heart disease.
        
    Hyperbaric oxygen therapy encourages the development of new (bypass) blood vessels to improve circulation.

  2. Immune system disruption may be caused by defective blood circulation. If diabetes is poorly controlled, white blood cells and macrophages that normally scavenge infection cannot reach the tissues where needed.
        
    Hyperbaric oxygen therapy delivers oxygen into tissues beyond where it can usually be reached by normal circulation. This makes the body more efficient in fighting infection. HBOT also can increase the efficiency of some antibiotic drugs.

  3. Neuropathy can affect both peripheral (motor and sensory) and autonomic (internal organ) nerve function.
    • Sensory neuropathy is when the patient experiences pain and numbness. Injury is more frequent when patients cannot feel environmental risks. Patients are less aware of tissue damage and infection and may continue to traumatize the injured joints and tissues of their feet.
    • Motor neuropathy weakens muscle groups. Foot and toe deformities, the result of altered bone and muscle structure, impair balance and coordination. Hammer toes and misshapen feet cause open ulcers, skin breakdown, and the destruction of protective callus.
    • Autonomic dysfunction decreases sweating and increases skin dryness. Scaling and cracking creates open wounds prone to infection.

    Infection may cause a dramatic rise in blood sugar levels, even for carefully controlled diabetics. This “spike” can be an effective marker for undiagnosed infection. Diabetic foot wounds are a major complication of diabetes and the number one reason for hospital admission of the diabetic patient.
    
Hyperbaric oxygen therapy has proven to be one of the most effective methods available for healing wounds other therapies cannot.

    AMPUTATION

    It is estimated that 5 to 6 percent of the U.S. population is diabetic with the annual health care cost exceeding $20 billion. More than $1.5 billion of that is the cost of lower extremity amputations as a result of diabetic foot infections.

    Untreated or undertreated foot infections can lead to bone infection. When tissue death, gangrene, and bone infection overwhelm a body’s ability to heal, amputation is often seen as the only alternative.

    Diabetic patients account for approximately fifty percent of all the lower extremity amputations performed for non-traumatic reasons.

    Although the incidence of amputation in diabetics remains unacceptably high, it is a poor and costly solution. When a limb is amputated, a diabetic patient is generally hospitalized for 40 days, with an additional six to nine months of rehabilitation.

    Many elderly diabetic amputees remain wheelchair bound for the rest of their lives because they lack sufficient energy, balance, and strength to walk. Being sedentary may lead to other health problems, including difficult-to-heal bedsores.

    Is that just how amputation is?

    No.

    Individuals who lose limbs traumatically can expect to be rehabilitated to full activity.

    SOCIAL COSTS OF DIABETIC AMPUTATION

    What are the social costs of amputation? Even though the individual experiences an irreversible decrease in the quality of life, amputation is also something that affects the larger society. Many diabetic amputees fail to maintain productive lives because they can no longer sustain gainful employment. Many require public assistance, at substantial cost.

    From children faced with seeing a parent deformed surgically to those family members and friends who become caretakers, the tragedy of diabetic amputation exacts a price not completely measured in dollars.

Heal your diabetic wounds. Make an appointment today to discuss what hyperbaric oxygen can do for you.

For a limited time, Dr. Spiegel will provide a free assessment to determine if you would benefit from this treatment.

Contact:

Dr. Allan M. Spiegel, M.D.
31608 U.S. Highway 19
Palm Harbor, Florida 34684

727.787.7077


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