Dr. S.K. narayan Dash
Cardiology Surgeon
Questions? We’re here to help! Fill the form or chat with us now.
Accurate diagnosis and an appropriate treatment plan for pain, injury, deformity or difficulty walking.
A foot problem in a person with diabetes should not be treated as an ordinary foot problem.
Diabetes can affect sensation, circulation, the skin and the structure of the foot. A small area of pressure or a minor wound may therefore progress without causing significant pain, particularly when protective sensation is reduced.
I provide assessment and treatment for diabetic foot problems including ulcers, infection, deformity and Charcot foot, with an emphasis on identifying the factors responsible for the problem and addressing them rather than treating the wound alone.
A diabetic foot ulcer is an open wound that commonly develops over an area exposed to repeated pressure or mechanical stress.
Loss of protective sensation, foot deformity, inappropriate footwear and abnormal pressure distribution can all contribute.
Treatment may involve:
Offloading is a particularly important component of treatment for neuropathic plantar ulcers. The appropriate method depends on the location and characteristics of the ulcer, infection or ischaemia, and the individual patient's circumstances.
Learn about Diabetic Foot UlcersInfection can develop in an existing diabetic foot wound and may spread into deeper tissues or bone.
Warning signs can include:
Assessment may require examination of the wound, laboratory investigations, imaging and evaluation for deeper infection or bone involvement.
Treatment depends on the severity and depth of infection and may involve antibiotics, wound care, offloading and surgical treatment when required.
Diabetic foot infection should be assessed promptly rather than managed by repeatedly changing dressings at home. Current IWGDF/IDSA guidance provides specific recommendations for assessment and management of diabetes-related foot infection.
Learn about Diabetic Foot InfectionCharcot neuro-osteoarthropathy is a condition in which bones and joints of the foot and ankle can progressively break down in the presence of significant neuropathy.
An early Charcot foot may appear simply as a warm, swollen foot. Pain may be surprisingly limited because protective sensation is reduced.
Early recognition is important because continued weight-bearing on an unstable foot can contribute to progressive deformity.
Treatment during the active phase commonly involves appropriate immobilisation and offloading, followed by a carefully planned transition towards protected weight-bearing and suitable footwear or orthoses. In selected patients with significant deformity or instability, reconstructive surgery may be considered.
IWGDF has dedicated guidance for diagnosis and management of active Charcot neuro-osteoarthropathy.
Learn about Charcot FootDiabetes-related neuropathy can be associated with changes in the shape and mechanics of the foot.
Prominent bones, claw toes, Charcot deformity and altered pressure distribution can create areas that repeatedly break down.
Treatment may include:
The objective is not simply to close a wound but to reduce the mechanical factors that caused it in the first place.
Learn about Diabetic Foot DeformityWhen a diabetic foot develops a complicated wound, infection, ischaemia or significant deformity, treatment often requires more than wound dressing.
The underlying factors need to be assessed together:
Pressure → Neuropathy → Infection → Blood supply → Bone/joint involvement → Deformity
Depending on the situation, management may involve wound care, offloading, debridement, infection treatment, vascular assessment and, when necessary, reconstructive procedures.
The aim is to preserve a functional limb whenever this is clinically appropriate, while recognising that some severe infections or tissue loss may require more extensive surgery.
Learn about Flat Foot
Dr. S.K. narayan Dash
Cardiology Surgeon
Questions? We’re here to help! Fill the form or chat with us now.
