Ulcer, Gangrene, Diabetic Foot

These are serious complications commonly seen in patients with chronic illnesses like diabetes. General surgeons often manage these conditions to prevent severe outcomes like infections, limb loss, or other complications.

1. Ulcer

An ulcer is a sore that forms on the skin or inside the body, caused by tissue damage and failure to heal properly.

Types of Ulcers:

• Venous Ulcer: Caused by poor circulation in the veins.
• Arterial Ulcer: Caused by inadequate blood supply to the affected area.
• Diabetic Foot Ulcer: Common in diabetic patients due to nerve damage (neuropathy) and poor circulation.

Symptoms:

• Pain in the affected area (varies based on type).
• Redness, swelling, and warmth around the sore.
• Open sore with possible discharge.
• Delayed healing.

Causes:

• Venous Ulcers: Occur due to varicose veins or chronic venous insufficiency.
• Arterial Ulcers: Result from poor blood flow due to peripheral artery disease (PAD).
• Diabetic Ulcers: Combination of nerve damage (neuropathy) and poor circulation (angiopathy).

2. Gangrene

Gangrene is tissue death caused by a lack of blood supply due to infection or serious injury. It requires urgent medical attention to prevent the spread of infection and limb loss.

Types of Gangrene:

• Dry Gangrene: Typically caused by chronic lack of blood supply (commonly in diabetic patients).
• Wet Gangrene: Caused by acute bacterial infection leading to tissue death and pus formation.
• Gas Gangrene: Caused by bacteria (Clostridium species) leading to rapid tissue destruction and gas production.

Symptoms:

• Cold, pale, and numb skin.
• Blistering or dark discoloration of affected tissues.
• Foul-smelling discharge (in wet gangrene).
• Severe pain or lack of sensation.

Causes:

• Chronic Conditions: Poor circulation due to diabetes, peripheral artery disease (PAD), or long-term smoking.
• Infection: Can occur due to severe wounds, infections like Clostridium bacteria.

3. Diabetic Foot

Diabetic foot is a term used to describe foot problems in people with diabetes, which arise due to poor circulation, nerve damage, and wounds that don’t heal properly.

Symptoms:

• Numbness, tingling, or pain in the feet.
• Open sores or ulcers that won’t heal.
• Swelling and redness.
• Infections, with possible discharge or bad odor.
• Skin discoloration or blackened tissue in severe cases.

Causes:

• Neuropathy: Loss of sensation in the feet due to nerve damage caused by diabetes.
• Poor Circulation: Leads to slow healing and increased risk of infection.
• Wounds or Injuries: Minor cuts or scrapes that develop into ulcers.

When to See a General Surgeon

• Ulcer: For large, non-healing ulcers or when infection sets in.
• Gangrene: For any signs of tissue death or spreading infection.
• Diabetic Foot: For chronic foot ulcers, infections, or loss of sensation in diabetics.

Dr. Abhijit Budhkar plays a crucial role in managing these conditions to prevent limb loss, reduce infection spread, and ensure proper healing.