Stadiums
The course of the diabetic foot disease can be divided into different phases. These phases, which are also called the Wagner-Armstrong stages, are one possible form of division. These describe the characteristics of a wound and also consider whether there is an inflammation or a circulatory disorder.
The description of the wound ranges from 0-5, where 0 is no injury and 5 is the worst condition spread over the whole foot. A letter is added to each number in this classification if only the wound is present in case A. Or in case B there is also an infection.
C is used if there is a circulatory disorder of the foot. And if an infection as well as a circulatory disorder is found, this is explained with the letter D. Due to this uniform classification of stages, the course of the disease can be adequately described and documented, even during shift changes or alternation of nursing staff. The correct therapy and the further course of wound treatment can also be adapted according to the respective stage.
Therapy
The treatment of the diabetic foot is directly related to the treatment of diabetes itself. A decrease in the findings on the foot can only be expected if the blood sugar adjustment is also successful. For this purpose, depending on the therapy concept of the diabetes, the blood sugar level must be measured regularly.
The long-term blood glucose value, the HbA1c, is also an important control value for optimal adjustment. The next important step is the regular control of the feet in the mirror by the patient and then also by the treating physician. The earlier the injury or wound is detected, the better it is possible to take action against it.
Preventive measures, such as medical foot care, orthopedic shoe insoles, daily foot care and special attention to possible injuries are also very advisable. In the case of a wound, it must then be treated by a doctor or a wound nurse at short intervals. Therapy with antibiotics or the removal of inflamed and damaged tissue may also be necessary.
If the blood supply to the foot is poor, surgical intervention with tissue removal is not recommended, as the injury can then become even larger. If an inflamed wound or ulcer on the foot is no longer treatable and the condition of the diabetic foot cannot be brought under control, amputation may be necessary in the worst case. If there is only diabetic damage to the nerves, there is a higher probability that only individual bones and pieces of tissue will have to be removed, but not part of the leg. If there is also reduced blood circulation in the leg, this means that wounds heal very poorly and bacteria are more difficult to control.
