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Method: ” Negative pressure wound therapy has been used extensively for the past few years for wound bed preparation and in some cases for wound closure. We took a subset of diabetic patients with limb/life threatening foot infections. We subdivided them into those with peripheral arterial disease (ABI <0.8 or > 1.3) and those without (ABI between 08.-1.3). All patients were debrided along anatomical lines and NPWT started within 48-72 hours. Our aim was to analyze the effect of NPWT on wound bed preparation in the diabetic foot and on the duration of antibiotic therapy.”

Results / Discussion: ”Average duration of therapy was 1.78 weeks. Out of 37 patients, 18 had Peripheral Arterial Disease. 32 patients had complete closure of wounds over an average period of 3 months. 2 patients with PAD did not close completely with wound care and needed either further surgical intervention or in one case went for lower limb amputation. Three patients died during the study.

Conclusion: ” Keeping WBP as the end point, NPWT definitely helped in the same with the average duration of complete granulation being 1.78 weeks. Patients with PAD needed longer duration of NPWT. At this point we found it unnecessary to continue antibiotics in all patients and thereby reduced duration of antibiotic therapy.”


Gangrene with Renal Disease & Diabetes

This was a patient referred from Saudi Arabia.

Chronic smoker, diabetic, peripheral arterial disease with end stage renal disease on hemodialysis thrice weekly. Patient had critical limb ischaemia and presented to us with gangrene of the left side first toe with  infection spreading to the proximal part of the foot with draining wounds.

Patient was operated, advanced wound care instituted and was also started on Hyper Baric Oxygen Therapy. Patient healed completely. Thereby the foot was saved and patient suffered loss of only one toe which was already gangrenous at presentation.

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Long Standing Leg Ulcer

Long standing foot ulcers. Known diabetic. This patient had multiple foot and leg ulcers and had been to multiple hospitals before approaching us. Basic investigations were done and patient was put into advanced wound care. In less than three months the ulcers had healed completely . #diabeticfootcare #diabeticulcer #diabeticfeet #footulcer #diabeticfootulcer #diabeticfoot #charcotfoot #charcotsfoot #pressureulcer #ulcersonfeet #footwound #diabeticulcertreatment #footdiabetic #footdiabetes #diabeticfootcareclinicinhyderabad #podiatrist #podiatristnearme best podiatrist in hyderabad diabetic hospital near me foot doctor near me best diabetic foot surgeon in hyderabad


Diabetic Foot Complications – Gangrene (Types, Causes and Symptoms)

Diabetes Foot Complications – Gangrene (Causes and Symptoms)

You must be wondering, what is the correlation between diabetes and the foot/foot problems? Read on to know more about how diabetes can commonly cause foot problems and also lead to complications like gangrene.

Uncontrolled sugars in the blood can cause diabetic neuropathy (1) – a condition that results in numbness or a tingly sensation in the limbs (foot/arm) of a person due to lack of blood flow. Lack of blood flow can affect the tissues in the body and lead to more severe diabetic foot problems like gangrene. 

Diabetes is among the most common causes of gangrene (2).

Numbness and not being able to feel pain can cause a diabetic patient to be unaware of any cuts/injuries that may occur in those parts of the body. Lack of blood flow is a real problem in people with diabetes as it takes longer for a wound to heal. Exposure of the open sore/ulcer/wound to dirt and dust may cause it to get infected and if not treated on time can also result in infections and problems like gangrene.


What is gangrene?

Gangrene is a condition where the tissues in the body die due to illness, infected wounds or other injuries. It more commonly occurs in the feet, toes, arms and fingers.

Diabetes and gangrene (Types)

Dry gangrene

It is more common in people with diabetes and occurs mainly in the limb areas of the body. It is the result of low blood flow in those parts of the body .It is a common diabetic foot problem. Most of the time, dry gangrene is aseptic. This is because bacteria fail to thrive in dry tissue (3). However, if it gets infected, it can turn into wet gangrene.

Symptoms of dry gangrene:

          Painful skin

          Cold/dry skin

          Darkening of the skin

          Peeling off of the black skin

Wet gangrene

Wet gangrene occurs when a wound gets severely infected and blood supply gets cut off to allow it to heal (4). It is often caused by infections in the dry gangrene. Once that happens, the wound does not heal or may take too long to heal. Wet gangrene is more dangerous than dry gangrene and if you notice any symptoms, consult a doctor immediately. 

Symptoms of wet gangrene:



          Darkening of the skin (change of color wherein the skin may appear red, blue or black)

          Pus in the blisters

          Bad odor from the pus

          Shiny skin without hair

          Crackling sounds from the affected area if you press on it


If you see any of these symptoms, consult a doctor immediately.

More about diabetes and the foot here.



Charcot Foot with Fracture

This is a case of diabetic charcot foot with fractured calcaneum. Patient had been to multiple hospitals before coming to us. Patient was asked to walk on the fractured calcaneum. No one bothered to take an x ray and only after we did an X ray we realised the patient had a fracture of the calcaneum. Patient came with a through and through wound on the plantar aspect of the foot, involving the heel. Calcaneum was evident on probing. We did advanced wound management and as the x ray show, the fractured calcaneum healed and patient was mobilised in customised footwear.