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‘85 per cent of all amputations due to diabetes are preventable’

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Diabetic foot ulcers precedes 84 per cent of all diabetes-related lower-leg amputations and require specialised care. Anand Shirur, CMD, South Asia & China, ConvaTec, explains about the need for effective wound management services to bring in a new paradigm in diabetic foot care, in an interaction with Lakshmipriya Nair

What are the steps to improve diabetic foot ulcer management in India?

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Anand Shirur

According to a recent WHO report on diabetes and associated ailments, five per cent of all diabetics’ patients are prone to foot ulcers every year. 30 per cent of the diabetics get admitted in hospitals for diabetic foot and the number of days spent by these patients in hospitals are more than the days spent due to all other complications. A diabetic patient is always prone to a foot ulcer but regular care must be taken to avoid such critical situations. A regular foot check up especially of the plantar area (foot sole), keeping the foot dry, using proper footwear, checking for vascularity and neuropathy are few measures which help in preventing an ulcer. It was estimated that an ankle is lost to diabetes somewhere in the world every 30 seconds; however, a more important fact is that up to 85 per cent of all amputations due to diabetes are preventable. Diabetic people with one lower limb amputation have a 50 per cent risk of developing a serious abrasion in the second limb within two years.

How is wound care in diabetic patients different?

Wound care, specially, chronic wound care, needs to be handled aptly for correct resolution of condition. In the current scenario, most of the foot ulcers are detected at very advanced stage. The key challenge in this case is to restore vascularity in the affected area to help promote healing of wound and recover the toe or affected area. It is vital for the patient to be put on an advanced treatment protocol that will include timely detection of the ulcer, usage of appropriate advanced wound care dressings like the ones with hydrofiber technology offered from ConvaTec, proper diet and oral medications, and regular checkups.

How can ConvaTec Wound Management Center help to streamline wound care?

Our “Advanced Wound Care Center” is a ray of hope for patients suffering from foot and limb associated diseases. Amputations and complications are preventable, as long as appropriate diagnosis and management is done at the right stage. With the launch of this clinic we aim to educate patients and reduce these complications.

The centre’s wound management plan includes a standardised record of clinical assessment and etiology of the wound. The model of care would be to apply a stepwise approach implementing advanced wound management modalities as a part of the wound care algorithm. All aspects of care from initial presentation to treatment and evaluation would be documented. Following assessment, treatment goals would be agreed with the patient and a time frame would be fixed for the achievement. Holistic and all round care as well as treatment would be ensured by addressing the underlying factors which could influence the potential for wound healing.

What are the major challenges in diabetic foot ulcer management?

The immediate major challenge for diabetic foot ulcer management is the stage at which it is being detected. The shift should be to move towards the prevention of diabetic foot ulcers in all diabetic patients. To be able to achieve this, a much higher level of awareness needs to be instilled in the population prone to this condition. Continuous improvement and ongoing patient education is a definite need of the hour.Only with awareness and education can there be an early intervention to prevent foot deterioration. The other major challenge, which has surfaced in the past few years, is the lack of a dedicated centre to diagnose/ treat such wounds. Most patients are unsure where to go when it comes to such chronic conditions. By the time they do the rounds of some centres and end up in a right one, they would have done considerable damage to the already ailing foot.

How will ConvaTec play a role in DFU management?

ConvaTec is a global MNC dealing with innovations in the field of advanced wound care management. With the help of its own patented Hydrofiber technology, the company is manufacturing and marketing dressings worldwide aiming to heal exudating and difficult to heal chronic wounds. As already highlighted, lack of awareness, a proper treatment centre etc. are big challenges in the Indian market for diabetic foot ulcer. ConvaTec has world class dressing to offer. In India, it is also a pioneer who has introduced the concept of an advanced wound management centre. In the year 2013, the first centre was launched in the Narayana Health City, Bangalore Campus in collaboration with the vascular sciences department of the hospital. The second such centre was recently set up in association with the M.S Ramaiah Memorial Hospital, Bangalore. These centres aim at providing a dedicated facility for all such major chronic wounds. They also provide diagnostic and treatment capacities and are manned by well trained nurses and experienced consultants to aid the process of prevention and healing of wounds. These centres also look at bridging gaps like the the lack of awareness and treatment options for patients with diabetic foot ulcer condition.

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