Treating Charcot Foot: Surgery or Not?

Treating Charcot Foot
If you have peripheral neuropathy, there’s a chance you could also develop Charcot foot. This condition weakens the bones of your foot, as well as your joints and soft tissues, while causing painful sores or changing the shape of your foot.

As many as 2.5 percent of patients with diabetes can develop Charcot foot, and it can recur in as many as five percent of cases.

Fortunately, your doctor can help you in treating Charcot foot, largely reversing the damage it causes. Depending upon the severity of your case, you could receive medical or surgical therapy. Any treatment option you receive will have similar goals: take weight off the injured foot, address bone disease, and prevent future foot fractures.

Charcot Foot Diagnosis 

Imaging scans can help your doctor determine what treatment type you need. X-rays offer detailed pictures of dense structures, such as bones. MRI and ultrasound provide good imaging of foot and ankle soft tissues, potentially identifying any bone infections. Bone scans are nuclear tests that can also identify bone infections. A specific test — an indium scan — tags your white blood cells and follows them to the infection site.

Treating Charcot Foot

Whether your doctor recommends surgical or non-surgical treatment, you will get the best long-term results if you closely follow your physician’s instructions. Most specifically, wait until he or she tells you it’s safe to put weight on your foot again.

Also, be sure to check your feet daily for any problems, including scrapes or lingering sores. If any exist, immediately contact your doctor. The sooner you get treatment, the more likely you are to have a good outcome.

Non-surgical treatment: Offloading — keeping your weight off your affected foot — is the most important part of treating Charcot foot without surgery. For anywhere from 8-to-12 weeks, you’ll wear a protective walking boot or cast. The protective footwear should stay in place until any redness, swelling, or heat disappears. The Charcot Restraint Orthotic Walker (CROW) is a commonly used device.

The second step is prescription orthotic shoes. These shoes must fit appropriately, providing enough room for your toes and enough cushioning for the heel, arch, and ball of your foot. The right shoes won’t have any pressure points, reducing the risk of injury or ulcers.

You’ll also need to change your activities to avoid repetitive trauma to both feet.

Surgical treatment: Surgery is recommended for individuals with severe ankle and foot deformities that could make using a brace or other orthotics difficult. These patients are also at a higher risk for developing foot ulcers.

Surgery could involve re-aligning the bones of your foot or removing some that could cause ulcers. According to recent research, most patients with diabetes are able to resume normal walking after surgery.

Because infection risk is high post-surgery, you’ll be instructed not to put your full weight on your foot until your doctor gives you the green light. You’ll also need to commit to wearing protective footwear for life.

Remember, it is possible for Charcot foot to return, so stay vigilant with your foot hygiene.

For more information on treating Charcot foot, contact the Amputation Prevention Centers of America.

How Oxygen Therapy Works | HBO Therapy

HBO Therapy
If you have a foot ulcer or leg wound that is linked to diabetes, you likely know how long these sores can linger. And, the longer they take to heal, the more vulnerable you are to infection and other risks. Speeding up the healing process is better for your health all around.

That’s where hyperbaric oxygen (HBO) therapy comes in. Research and clinical experiences show this therapy can reduce the presence of certain non-healing wounds. It can also speed up how quickly they improve. The key is increasing the amount of oxygen that reaches injured tissue.

How is HBO Therapy performed?

HBO therapy exposes patients to 100 percent oxygen inside a pressurized chamber that has up to three times the air pressure of our everyday environment. During the session, the lungs are able to take in more oxygen than they usually can, funneling it into the blood stream. That’s critical because more oxygen equals more healing.

What does oxygen do?

Your body’s tissues need oxygen to function properly, and they also need it to fix any problems, such as wounds or sores. During HBO therapy, oxygen dissolves into the body’s fluids, including blood, plasma, and central nervous system fluids. The oxygen can easily be transported through the circulatory system. Once it reaches a foot ulcer or leg wound, oxygen increases the ability of white blood cells to kill bacteria.  It also helps to fight infection, and reduce swelling. Additionally, it helps the body grow new blood vessels that will continue to help oxygen reach injured tissue.

How good are the results?

Recent clinical trials show HBOT can be an effective tool in improving the condition of long-lasting foot ulcers or leg wounds. The Journal of Anesthesiology Clinical Pharmacology conducted a study that followed 30 individuals with chronic non-healing wounds for 30 days. The participants treated with HBO therapy saw a 59% reduction in wound area. Patients treated with more conventional therapies only saw a 26% improvement.

Other studies also showed HBO therapy can improve the condition of these wounds. An additional 12 randomized trials involving 577 people, many of whom reported having diabetic foot ulcers, showed positive results. Based on the study outcomes, patients who received HBO therapy saw foot ulcer improvement at six weeks. HBO also reduced the size of leg vein wounds.

Contact the Amputation Prevention Centers of America if you have any questions regarding HBO therapy.

What’s Behind that Non-Healing Wound? | Living with Diabetes

non-healing wound

A non-healing wound that lingers can be annoying, but it should also be cause for great concern — especially if you have diabetes or are in the early steps of developing the disease. Chronic non-healing wounds, especially those that won’t heal within three months, can impact you more frequently and more significantly.

According to the Centers for Disease Control & Prevention, chronic wounds affect approximately 5.7 million adults, leading to nearly $20 billion in medical care costs. Knowing why these long-lasting sores develop can not only improve your health, but it could also reduce your medical expenses.

How Diabetes Puts You at Risk with a Non-Healing Wound

Diabetes does increase the likelihood that you’ll develop a chronic wound at some point. These sores frequently start small, such as a small pimple or scratch. However, even after repeatedly scabbing over, they won’t heal. If you notice this type of wound, contact your doctor for medical attention immediately.

According to the Cleveland Clinic, there are three factors that increase your risk for developing a chronic wound:

  1. Neuropathy: Having limited feeling in your feet makes it harder to notice any small cuts or trauma to your feet. This increases your infection risk and can lead to a chronic wound.
  2. Poor blood flow: Poor circulation limits how well your blood can bring the cells to your wound that can increase your likelihood of healing.
  3. Infection: With diabetes, it’s harder for you to fight off infection. If your wound becomes infected, it could progressively worsen, putting you at risk for amputation.

 

Reducing Your Risk with Non-Healing Wounds

Although having diabetes makes you more vulnerable to chronic wounds, you can take steps to decrease your chances or bolster your healing abilities.

  • Proper footwear: Choose properly-fitted shoes that won’t create sores on your feet. Avoid pointed-toe shoes or ones that are too flat or high heels because they make it harder to distribute your foot pressure. Soft insole leather, canvas, or suede shoes will let your feet breathe, and laces, buckles, or Velcro will make adjusting shoes easier.
  • Manicure your toenails: Be sure to keep your toenails cut short. Longer nails put you at risk for scratches you might not be able to feel. Visit a podiatrist for foot care.
  • Control your blood sugar level: Actively monitor your glucose. If you’re pre-diabetic, make healthy food choices and exercise to control your weight and blood sugar levels. Your doctor could conduct an A1C test, measuring the percent of blood sugar attached to your red blood cells, to determine your blood sugar level over the past 2-3 months.
  • Eat well: Stay hydrated, and eat complex carbohydrates that help control your blood sugar, such as whole grains and vegetables. Also, be sure to eat enough protein because it supports new cell and tissue growth needed for wound healing. Chicken, fish, turkey, eggs, yogurt, peanut butter, and cheese are good options. Limiting your fat intake can also improve your immune system.

Ultimately, you need to take a chronic wound seriously. Don’t delay treatment — see your doctor or contact the Amputation Prevention Centers of America as soon as you notice a non-healing wound or sore.