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Type 2 diabetics with painful leg wounds now have an additional treatment option - maggots. Placing maggots on open wounds may seem like a dreadful treatment, but it's less painful than the alternative.

Creepy-Crawlies Just What the Doctor Ordered for Wound Debridement

Type 2 diabetics with painful leg wounds now have an additional treatment option- maggots. At first, placing maggots on open wounds may seem like a dreadful treatment, but this option is actually much less painful than the alternative.

How Wounds Develop on Diabetic Legs

After 10 to 20 years of poor control of their blood sugars, many type 2 diabetics start having major problems with skin wounds in their legs. Usually the problem at first is poor circulation in the veins of their their legs. This complication of diabetes presents the opposite symptoms of the much more widely publicized condition known as peripheral arterial disease (PAD).

Diabetics who have venous insufficiency usually feel better when they get up and around. Walking makes their legs feel better. The poor circulation in the legs at first causes just a constant itch that is much worse after showering or heating the leg. Then the skin on the legs gets so dry that it turns brown. Usually a misadventure with a diabetic skin treatment product makes the legs break out in eczema, and then tiny holes in the skin get infected. The poor circulation under the legs makes them a prime target for bacterial infection.

Diabetic foot and leg ulcers can also be started by poorly fitted socks and shoes. Footwear rubs against the skin and causes a blister. The blister is not noticed and is not treated, and it becomes infected. When the infection is limited to the skin, it is relatively easy to treat, but some infections take only a few days to penetrate muscles, tendons, and bones. Diabetics who have peripheral neuropathy may never feel initial pain from the infection.


Half of All Diabetics With Leg and Foot Wounds Eventually Need Amputation

An alarmingly large number of  diabetics who develop foot and leg wounds eventually have to have an amputation of the limb. The deeper the wound, the more important it is to keep it clean. When infection reaches the bone, a painful procedure known as debridement is necessary to remove tiny bits of bone and muscle that may be infected and out of reach of antibiotics. In debridement, a surgeon strips out infected bone or tendons to keep a wound clean in the hopes that eventually it may heal.

Debridement is accompanied by treatment with multiple antibiotics, usually for nine months to a year. Many of the antibiotics used to treat infected wounds cause anemia, nausea, and vomiting. Some also cause serious skin reactions.

In diabetics who also have problems with kidney function, antibiotic treatment increases the risk of kidney failure. This is especially a problem when the infectious agent is methicillin-resistant Staphylococcus aureus (MRSA), which usually has to be treated with an antibiotic known as vancomycin. Kidney damage is common with the use of vancomycin.

When there is a tradeoff between gangrene of the foot and having to go on dialysis, doctors will usually sacrifice the foot or leg to save the kidneys. This happens in about 50% of all cases of diabetic leg and foot wounds that go deeper than the skin. But doctors keep searching for ways to remove infected tissue without the horrible side effects of potent antibiotics.



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