Preventable amputations of diabetic feet

Many foot amputations in diabetics could be avoided

07.09.2011

Every year around 28,000 so-called diabetic feet have to be amputated here. Much of these amputations would be preventable with adequate medical care for diabetics, said the director of the Institute of Clinical Pharmacology at the University of Rostock, Bernd Drewelow, in the run-up to the 12th Rostock Antiinfektivatagen this weekend.

The significantly poorer circulation of the feet due to diabetes means that bacteria that settle in open wounds can only be controlled inadequately and threaten serious infections, explained Bernd Drewelow. Diabetics therefore suffer from an increased susceptibility to infections, which can bring dangerous ulcers in the area of ​​the feet even with the smallest injuries, which in the worst case an amputation of the foot is required, the expert reported. However, they settled „far more than half“ avoid the approximately 28,000 amputations of diabetic feet per year, if an early start with medical treatment, stressed the Director of the Institute of Clinical Pharmacology.

Causes of diabetic feet
The development of the clinical picture of a diabetic foot is usually preceded by infections caused by bacteria, which penetrate into the organism in case of injuries and can not be sufficiently controlled by the immune system due to the poor blood circulation. The living conditions in the poorly healing wounds favor the growth of bacteria and threaten massive ulcers, which often require an amputation of the foot, explained Bernd Drewelow.

In addition to circulatory disorders, according to the expert further factors in diabetics favor the risk of infections in the feet. As a result, the nerves are often damaged in the course of the disease, making the feet less shock and pressure sensitive. The risk of injury increases and often smaller wounds are not noticed by those affected, warned the Drewelow. Since diabetics' eyesight is also relatively frequently impaired, they often register the resulting inflammation late, according to the director of the Institute of Clinical Pharmacology.

Medical treatment important for avoiding amputation
Difficulties in the treatment of the diabetic foot arise, according to Bernd Drewelow, for example, from the handling of medical staff and doctors with the disease. So would „many doctors, even caregivers and those affected disgust themselves at such feet.“ Respectively, treatment is often started. But amputation avoidance requires immediate action, according to Drewelow. Thus, in a first step, the dead tissue should urgently be removed in order to prevent a further spread of the infection, said the expert. Thereafter, an antibiotic-based treatment is recommended, but the drugs are often difficult to reach due to poor tissue perfusion, says the director of the Department of Clinical Pharmacology. Therefore, once the bacterial strains have been identified, out of the approximately 100 available antibiotics, those that can reach the affected tissue must be selected for treatment, Drewelow emphasized.

Promote blood circulation of the feet
The diabetics recommend the expert to do something himself to improve blood circulation in the feet. It can be achieved by physical activity and exercise significant positive effects, said Drewelow. An improvement of the blood circulation in the legs and feet can also be achieved, for example, with the help of so-called Kneipp cures (Kneipp and water treading). To avoid infections and the associated diabetic foot, according to Bernd Drewelow also a careful foot care is particularly important. (Fp)

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