Diabetic Foot Treatment in Pune: Ulcer Care, Surgery and Limb Protection

What is a diabetic foot?

Diabetes can damage the foot in three ways, which often occur together:

• Nerve damage (neuropathy): loss of feeling means that a blister, cut or pressure point goes unnoticed and becomes an ulcer.
• Poor blood flow (peripheral artery disease): narrowed arteries slow healing and raise the risk of gangrene.
• Infection: high blood sugar weakens the body’s defence, so infection can spread quickly into deeper tissue and bone.

“Diabetic foot” covers the problems that result: ulcers, infections, abscesses, gangrene, bone infection (osteomyelitis) and Charcot foot, where weakened bones collapse and the foot changes shape.

Who may benefit, and how is the foot assessed?

Anyone with diabetes and a foot wound, infection, colour change or deformity should be assessed promptly. The assessment covers:

1. The wound: size, depth, whether bone can be felt, and signs of infection.
2. Sensation: testing with a fine filament or tuning fork.
3. Blood flow: foot pulses, and ankle or toe pressure measurements; a vascular opinion if blood flow is poor.
4. X-ray or other scans to look for bone infection or Charcot changes.
5. Blood tests: sugar control, kidney function and infection markers.

What are the treatment options?

Treatment	Purpose	Points to consider
Offloading (cast, boot, special footwear)	Takes pressure off the ulcer	Needs to be worn consistently; walking is limited
Debridement	Removes dead tissue and callus so the wound can heal	Often repeated
Infection treatment	Antibiotics; urgent drainage of pus	Deep infection needs surgery
Restoring blood flow	Angioplasty or bypass by a vascular surgeon	Needed before major surgery if flow is poor
Dressings and negative pressure therapy	Prepare the wound bed for healing	Regular dressing changes
Skin grafts and flaps	Close clean wounds that will not heal alone	Needs adequate blood flow and offloading
Toe or partial foot amputation	Removes tissue that cannot be saved	Planned to keep as much function as possible

Wound closure techniques are described under skin grafting surgery, and planned amputation under amputation surgery.

How is diabetic foot surgery performed?

1. Urgent drainage and debridement for infection: pus is drained and dead or infected tissue, and sometimes bone, is removed, with samples sent for culture.
2. Wound preparation: repeated debridement, dressings or negative pressure therapy until the wound is clean and healthy.
3. Closure: a skin graft for a shallow wound on a non-weight-bearing area, or a local flap for deeper wounds and pressure areas.
4. Offloading and protection while the wound heals.
5. Long-term prevention: footwear, podiatry and regular review.

How should you prepare, and what should you ask?

• Bring your diabetes records, medicines list and recent blood sugar readings.
• Bring the footwear you usually wear.
• Stop smoking; it reduces blood flow to the feet.

Questions to ask:

• Is the wound infected, and does the bone look involved?
• Is the blood flow good enough for healing?
• How do I offload the foot at home and at work?
• What will prevent another ulcer?

What is recovery like?

Time	What to expect for most patients
First days	Infection control, dressings and offloading; sometimes a hospital stay
Weeks 1-4	Regular dressings; repeated debridement if needed; graft or flap when the wound is ready
Weeks to months	Gradual healing with offloading; return to walking as advised
After healing	Protective footwear, podiatry and regular foot checks for life

What are the risks?

• Wound breakdown or graft loss, especially if pressure continues on the area.
• Spread of infection, which can threaten the limb or life if not treated early.
• Further surgery, including amputation, if healing fails.
• Ulcer recurrence after healing.
• Anaesthetic and medical risks, higher in people with heart or kidney disease.

What results can you expect?

Many diabetic foot ulcers heal with early, well-coordinated care, and limb loss can often be avoided. Healing can take weeks to months. Because the risk of a new ulcer stays high, prevention continues for life.

What affects the cost of diabetic foot treatment in Pune?

• Severity: a shallow ulcer, deep infection or gangrene.
• Procedures: debridement, grafts, flaps, amputation and any vascular treatment.
• Hospital stay, antibiotics and dressings, including negative pressure therapy.
• Offloading devices, footwear and follow-up.

Diabetic foot treatment is medical care and is often covered by health insurance, subject to your policy.