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Diabetic Foot Ulcer Treatment

The ulcers on your foot that are not healing can be a sign of diabetic foot ulcers. Reach out to an experienced vascular surgeon and get safe and advanced diabetic foot ulcer treatment as soon as possible to avoid possible complications. Book your appointment today with the best vascular surgeon.

The ulcers on your foot that are not healing can be a sign ... Read More

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  • What is Diabetic Foot Ulcer?

    A diabetic foot ulcer is a medical condition in which the patient suffering from diabetes develops wounds in the foot which further grows to be an ulcer due to lack of proper blood circulation in the affected area. When a person with diabetes develops a foot injury, such as a blister, cut, or sore, they may not be aware of it due to the loss of sensation. The injury can go unnoticed and untreated, leading to the formation of a diabetic foot ulcer. If left untreated, diabetic foot ulcers can become infected and may lead to serious complications, such as skin infection, bone infection, or tissue death.

    • Disease name

    Diabetic Foot Ulcers

    • Surgery name

    Debridement

    • Duration

    1 -2 Hours

    • Treated by

    Podiatrist

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    What Are the Types of Diabetic Foot Ulcer?

    Diabetic foot ulcers are a serious complication of diabetes, often starting with a seemingly minor injury that can worsen rapidly due to nerve damage and poor blood flow circulation. While the initial symptoms like swelling, itching, and burning might seem manageable, neglecting these ulcers can lead to severe consequences. Here are a few types of diabetic foot ulcers that must be considered while taking treatment:

    • Neuropathic Ulcers: These ulcers develop due to nerve damage that numbs the feet, masking injuries like cuts or blisters from ill-fitting shoes. They can appear anywhere on the foot and range from calloused patches to open sores with varying colors. It is considered the most common form of diabetic foot ulcer.
    • Ischemic Ulcers: Poor blood circulation is the main reason behind these ulcers. Narrowed arteries restrict oxygen and nutrients from reaching the feet, hindering wound healing and leading to tissue death. These ulcers often appear on the toes and heels, with a pale or reddish hue.
    • Neuroischemic Ulcers: Due to nerve damage and poor circulation, neuroischemic ulcers are formed. They frequently occur on the tips of toes or under thick toenails, combining the characteristics of both neuropathic and ischemic ulcers.

    Early detection and proper management are crucial to prevent diabetic foot ulcers from progressing and having any severe complications. Regular foot checks, proper footwear, and maintaining good blood sugar control are essential steps in keeping your feet healthy. Remember, even a small injury can have serious consequences for diabetic feet, so don’t hesitate to seek medical attention if you notice any changes.

    Are you going through any of these symptoms?

    Diagnostic Tests Before Diabetic Foot Ulcer Treatment

    Before embarking on the journey of treatment for diabetic foot ulcers, a thorough diagnosis is performed by the doctor to assess the overall health of the patient. This diagnostic phase helps pave the way for a personalized treatment plan with the best chance of success.

    Here are some of the tests mentioned that a doctor may perform to evaluate the patient’s health:

    • Clinical Assessment: The doctor carefully inspects the foot ulcer. They analyze the size, depth, and appearance of the ulcer, revealing the situation of the wound. Signs of infection or inflammation are like flashing red lights, demanding immediate attention.
    • Wound Cultures: If infection is suspected, a wound culture comes into play. In this diagnosis, the doctor collects a small sample of tissue from the ulcer and sends it to the lab for the test. By identifying the issue, the doctor can prescribe the most effective antibiotic medicine to treat the ulcer.
    • X-ray: X-rays reveal hidden injuries beneath the surface. In this case, they help detect bone issues like osteomyelitis (bone infection) caused by the ulcer.
    • Doppler Ultrasound: Doppler ultrasound acts like a sonar, listening to the flow and identifying any blockages or slowdowns. This helps the doctor to understand if poor blood circulation is hindering the healing process in the affected foot.
    • Ankle-Brachial Index (ABI): This simple test compares the blood pressure in the ankle to that in the arm. Generally, this test is done to reveal which side is stronger. A low ABI indicates weak blood flow in the legs, a potential blockage to wound healing.
    • Monofilament Test: This test checks for numbness. A thin nylon filament, like a delicate feather, is gently touched to different parts of the foot. If the patient doesn’t feel it, it could be a sign of neuropathy, increasing the risk of developing ulcers.
    • MRI Scan: MRI scan provides a comprehensive view of the soft tissue around the ulcer. It can reveal hidden infections and structural abnormalities and even assess the extent of tissue damage, guiding the surgeon’s approach. In severe cases, most doctors recommend these tests.
    • Vascular Studies: For a closer look at the blood vessel network, advanced tests like angiography or magnetic resonance angiography might be employed. Imagine them as high-powered microscopes, offering a magnified view of any blockages or narrowings that could be impeding blood flow.
    • Biopsy: In rare and complicated cases, a tissue biopsy might be necessary. This involves taking a tiny sample of the wound to be examined under a microscope in a lab.
    • Complete Blood Count (CBC): This test acts like a general health check-up for the blood. It reveals the levels of red blood cells, white blood cells, and platelets, providing insights into the body’s overall health and ability to fight infection. This test is recommended before the treatment.
    • HbA1c Test: This test offers a window into the past, revealing average blood sugar levels over the past two to three months. It helps assess long-term glycemic control and informs decisions about how to optimize diabetes management before and after any treatment.

    Different Treatment Options for Diabetic Foot Ulcer

    The treatment of diabetic foot ulcers generally involves a multidisciplinary approach involving healthcare professionals to guide the patient properly with the treatment procedures. The specific treatment options depend on the severity and characteristics of the ulcer, for a better and permanent cure, the doctor always advises surgical intervention, but the patient can always try the conservative methods prior.

    Here are some of the common treatment options for diabetic foot ulcer:

    • Wound care and dressings: Proper wound care is essential for diabetic foot ulcers. The wound is cleaned and dressed using sterile techniques to prevent infection. Various types of dressings may be used, such as hydrogels, foams, films, or antimicrobial dressings, depending on the wound characteristics.
    • Debridement: Debridement involves the removal of dead or infected tissue from the ulcer. This can be done through various methods, including sharp debridement (using a scalpel or scissors), mechanical debridement (using a whirlpool bath or specialized dressings), enzymatic debridement (using topical enzymes), or autolytic debridement (using moisture-retentive dressings to promote natural wound healing).
    • Offloading: Offloading refers to reducing pressure on the foot ulcer to promote healing. This can be achieved through various methods, such as using specialized footwear, custom orthotic devices, casts, boots, or crutches. Offloading helps to relieve pressure. 
    • Hyperbaric oxygen therapy (HBOT): HBOT involves breathing pure oxygen in a pressurized chamber, which increases the amount of oxygen in the bloodstream. This can promote wound healing by enhancing oxygen delivery to the tissues. HBOT is generally used for more severe or non-healing ulcers.
    • Joint Fusion or Removal: In the situation, where an infected joint is contributing to the ulcer, joint fusion (arthrodesis) or removal (joint disarticulation) is considered for removing the source of infection. 

    It is important to note that the treatment approach may vary depending on individual circumstances, and a healthcare professional should be consulted for proper evaluation and management of diabetic foot ulcers.

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    Preparation before Diabetic Foot Ulcer Treatment

    Before undergoing Diabetic Foot Ulcer Treatment, several important preparations need to be made. Here are some key considerations:

    • Medical evaluation: A comprehensive medical evaluation is performed before surgery to assess the patient’s overall health and to identify any underlying conditions that may affect the surgical outcome or recovery. This evaluation may include a review of the patient’s medical history, physical examination, blood tests, and possibly imaging studies.
    • Glycemic control: It is crucial to optimize blood sugar control before surgery to reduce the risk of complications and promote healing. This may involve working closely with an endocrinologist or diabetes specialist to adjust medication dosages, monitor blood sugar levels, and follow a specific diet plan.
    • Smoking cessation: Smoking can impair wound healing and increase the risk of complications. It is strongly advised to quit smoking before foot ulcer surgery.
    • Preoperative instructions: The healthcare team will provide specific instructions to the patient regarding fasting (not eating or drinking) before surgery. It is important to follow these instructions to minimize the risk of complications during anesthesia.

    What Happens During Diabetic Foot Ulcer Treatment?

    During Diabetic Foot Ulcer Treatment, the specific procedures performed will depend on the characteristics and severity of the ulcer, as well as the individual patient’s condition. Here are some common surgical interventions that may be performed:

    • Debridement: Surgical debridement is often the first step in treating a diabetic foot ulcer. It involves the removal of dead or infected tissue from the wound. The surgeon carefully removes the non-viable tissue, debris, and any foreign objects to promote healing and prevent infection.
    • Wound closure: After debridement, the surgeon may assess the wound to determine the best method of closure. In some cases, the wound may be left open to heal gradually from the bottom up (secondary intention healing) or with the use of specialized wound dressings. In other cases, the wound may be closed primarily using stitches, sutures, or skin grafts.
    • Skin grafting: If the ulcer is large or deep, a skin graft may be necessary. In this procedure, healthy skin is taken from another part of the body (donor site) and transplanted onto the wound. The grafted skin provides a new surface for healing and promotes the growth of new tissue.
    • Infection control: If there is an active infection, the surgeon may perform additional procedures to control and manage the infection. This may involve removing infected tissue, draining abscesses, or using antibiotic therapy.

    Benefits of Diabetic Foot Ulcer Treatment

    The benefits of diabetic foot ulcer treatment are numerous and significant. Prompt and effective treatment can help improve the healing process, prevent complications, and enhance the overall quality of life for individuals with diabetic foot ulcers. Here are some specific benefits of diabetic foot ulcer treatment:

    • Wound healing: Proper treatment helps promote the healing of diabetic foot ulcers. This can prevent the ulcers from becoming chronic, non-healing wounds, which can lead to severe complications and even amputation. Treatment methods such as wound debridement, dressings, and advanced wound care products can facilitate the healing process.
    • Infection prevention and control: Diabetic foot ulcers are prone to infection due to compromised immune function and impaired blood circulation. Timely and appropriate treatment can help prevent infections or control existing infections. This reduces the risk of complications such as cellulitis, osteomyelitis, and sepsis.
    • Reduction of pain and discomfort: Diabetic foot ulcers can cause significant pain and discomfort, making it challenging for individuals to perform daily activities and maintain a good quality of life. Treatment can alleviate pain and discomfort associated with the ulcers, allowing individuals to regain their mobility and functionality.
    • Prevention of amputation: Diabetic foot ulcers, if left untreated or poorly managed, can progress to a point where amputation becomes necessary to prevent the spread of infection or to save the person’s life. Proper treatment can significantly reduce the risk of amputation by promoting wound healing, controlling infections, and addressing underlying factors contributing to ulcer development.
    • Prevention of recurrence: Treating diabetic foot ulcers not only addresses the current wound but also helps reduce the risk of future ulcer development. By addressing underlying factors such as poor blood sugar control, foot deformities, and inadequate foot care, treatment can help prevent the recurrence of foot ulcers.

    It is important for individuals with diabetic foot ulcers to seek early and appropriate treatment from healthcare professionals experienced in managing diabetic foot complications. Timely intervention and a comprehensive treatment approach can maximize the benefits and improve outcomes for individuals with diabetic foot ulcers.

    Possible Complications and Side Effects Of Diabetic Foot Ulcer Treatment

    While diabetic foot ulcer treatment aims to promote healing and prevent complications, there can be potential complications and side effects associated with the treatment.

    • Infection: Diabetic foot ulcers are prone to infection, and despite treatment efforts, infections can occur or persist in some rare cases. Prompt and appropriate management of infections is crucial to prevent further complications.
    • Delayed wound healing: Diabetic foot ulcers may take a long time to heal, and in some cases, they may not heal completely. Factors such as poor blood circulation, impaired immune function, high blood sugar levels, and underlying medical conditions can contribute to delayed wound healing.
    • Recurrence of ulcers: Even after successful treatment, there is a risk of ulcer recurrence. Without proper preventive measures, such as regular foot care, appropriate footwear, and ongoing management of diabetes, new ulcers can develop.
    • Skin graft or flap complications: In cases where skin grafting or flap reconstruction is performed, there can be complications related to the procedure. These may include graft or flap failure, poor graft or flap adherence, infection, or tissue necrosis.
    • Adverse reactions to medications: Some medications used in diabetic foot ulcer treatment, such as antibiotics or pain medications, can cause side effects or allergic reactions. It is important to inform healthcare providers about any known allergies or previous adverse reactions to medications.
    • Wound breakdown: In some cases, the surgical wound may break down or fail to heal properly. This can result in an open wound or a chronic non-healing wound that requires further interventions or specialized wound care.

    It is important to note that not all individuals will experience these complications or side effects, and proper management and adherence to treatment plans can help minimize their occurrence. Regular monitoring by healthcare professionals and open communication with the care team is essential to address any concerns and manage complications effectively.

    Recovery Process of Diabetic Foot Ulcer after Treatment

    The recovery process of a diabetic foot ulcer can vary depending on the severity of the ulcer, the individual’s overall health, and the effectiveness of the treatment. Here are some general steps and considerations involved in the recovery process after treatment:

    • Lifestyle modifications: Making certain lifestyle modifications can help support the healing process. This may include quitting smoking (as smoking can impair wound healing), maintaining a healthy diet, engaging in regular physical activity (if recommended by a healthcare professional), and practicing good foot hygiene.
    • Blood sugar control: Managing blood sugar levels is vital for the healing process. Elevated blood sugar levels can impair wound healing, so it is important to follow a diabetes management plan, which may include dietary changes, medication adjustments, or insulin therapy. Working closely with a healthcare professional, such as a diabetologist or endocrinologist, is crucial for achieving and maintaining optimal blood sugar control.
    • Wound care: Proper wound care is essential for healing. This may involve cleaning the wound, removing dead tissue (debridement), applying dressings, and using specialized wound care products. It is important to follow the healthcare professional’s instructions for wound care and adhere to the recommended dressing changes.
    • Offloading: Offloading refers to reducing pressure on the affected foot to promote healing. This can be achieved through the use of special footwear, shoe inserts, or casts. Offloading helps to relieve pressure from the ulcer and allows for better blood circulation to the area, aiding in the healing process.
    • Infection control: If there is an infection present, it is crucial to treat it with appropriate antibiotics as prescribed by a healthcare professional. Controlling the infection is important for preventing further complications and promoting wound healing.
    • Regular follow-up appointments: It is essential to attend regular follow-up appointments with the doctor to monitor the progress of the wound and make any necessary adjustments to the treatment plan. During these appointments, the doctor may perform wound assessments, provide guidance on wound care, assess circulation, and address any concerns or complications that may arise.

    The recovery process can take weeks to months, depending on the size and depth of the ulcer. It is important to note that each individual’s situation is unique, and the recovery process may differ. Close collaboration with the vascular surgeon and adherence to their recommendations are crucial for optimal healing and minimizing the risk of complications or ulcer recurrence.

    Diabetic Foot Ulcer Treatment Cost in India

    The cost of diabetic foot ulcer treatment in India ranges from Rs. 40,000 to Rs. 2,50,000. However, it is only an estimated cost range that varies for each patient, depending primarily on the diabetic foot ulcer stage. Additional key factors that influence the cost of treatment are listed below:

    • The severity of the condition and extent of damage done to the deep veins, muscles, and bones. 
    • The method chosen to treat the ulcer (surgical or non-surgical).
    • The surgeon’s consultation and operating fees. 
    • Diagnostic tests performed before and after surgery. 
    • Medications prescribed to the patient. 
    • The choice of hospital and hospitalization expense. 
    • Post-surgery care and follow-up consultations. 

    The overall cost of treatment is calculated based on the above-listed factors. The good thing is that diabetic foot ulcer treatment is covered under insurance as it is a critical condition. The treatment is deemed a medical necessity. Thus, patients only need to file a claim request to acquire authorization, and the insurance company will cover the expenses entirely or partially as specified in the policy. 

    FAQs about Diabetic Foot Ulcers

    How long is the treatment for diabetic foot ulcer?

    The duration of diabetic foot ulcer treatment depends on the severity of the wound. In early-stage diabetic foot ulcer, the treatment may take 3 to 8 weeks approximately. In severe cases, patients may require 3 to 6 months to heal completely.

    Is diabetic foot ulcer treatment covered under health insurance?

    The good thing is that diabetic foot ulcer surgical treatment is covered under insurance as it is a critical condition. The treatment is deemed a medical necessity. However, the patients are required to file a claim request to get the authorization, and then the insurance company will take care of the expenses may be completely or partially, as mentioned in the policy.

    What is the home remedy for diabetic foot ulcer?

    Some popular home remedies for treating diabetic foot ulcer, that patients can try involve using flaxseed oil, vitamin E, aloe vera, tea tree oil, etc. The patient may also explore some natural ingredients, which consist of antibacterial and healing properties that tend to give relief to the symptoms of diabetic foot ulcer, but would not completely eradicate the issue. Thus, it will be best to consult a vascular doctor immediately to get proper treatment.

    What happens if a diabetic foot ulcer is left untreated?

    In diabetic patients, foot complications are very common, and foot ulcers among them are a bit more serious. Patients who develop diabetic foot ulcers have a high risk of infection if the condition is not managed properly. Ultimately, the infection can spread to the bone and may even result in tissue death, which will require amputation.

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    Content Reviewed By
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    Dr. Amol Gosavi
    23 Years Experience Overall
    Last Updated : March 30, 2024

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      Ranbir Malhotra

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      Dealing with diabetic foot ulcers was worrisome, but Pristyn Care's medical team managed my condition with care and precision. The wound care treatment was effective, and my foot ulcers have healed significantly. Pristyn Care's diabetic foot ulcer management is top-notch.

      City : NASHIK