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Diagnosis Treatment

Diabetes control is the first step. Detect and treat risk factors such as high cholestrol , uric acid ,and homocysteine levels and watch out for associate system involvement such as retinopathy , neuropathy and ischemic heart diseases as they are relevant in further treatment. Test for culture of organisms and sensitivity to antibiotics. Use appropriate dressing and start a broad-spectrum antibiotic.


Also check for level and extent of block of the arterial blood vessels. Physicians should take care to prepare the kidneys for the dye used during limb angiography. To improve blood circulation to the legs , blood thinners ( aspirin , clopidogrel ) cholestrol lowering drugs ( statin ) ,haemorrheological agents (cilostazol ), can be taken on the advice of doctors. Angioplasty and stenting ( similar to that used in heart vessels ) can also be done. Or if the block is too long , bypass ia an option.

Once the circulation improves, doctors can go for a debridement ( a process where the infected/ dead tissue is cut off from the wound). This prevents viable tissue dying from poor blood flow. The only exception is the presence of abscess or pus that needs to be drained immediately.
By Dr Paresh Pai Vascular and endovascular surgeon.
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