Widespread leg ulcers due to diabetes complications

On October 22, Dr. Lam Van Hoang, Head of the Department of Endocrinology – Diabetes, Tam Anh General Hospital, Ho Chi Minh City, Tam Anh General Clinic, District 7, said that Mr. Tung’s wound had superficial ulcers. , has not affected deep tissues and bones. Surrounding the ulcer are patches of thick, keratinized skin due to prolonged inflammation. “This is a chronic wound formed on the basis of diabetic bullous disease,” Dr. Hoang said, adding that the patient did not take care of the wound properly, such as constantly touching it, changing the bandage incorrectly, and applying antiseptic solution. Incorrect bacteria damage granulation tissue.

Granulation tissue is new connective tissue containing microscopic blood vessels and myofibroblasts that grow at the wound site during the healing process. Damaged granulation tissue destroys skin structure, disrupts the defense barrier, leading to damage to the surrounding area.

Mr. Tung was evaluated by the doctor for in-depth complications of his feet, factors related to the healing process such as atherosclerosis, blood perfusion status, and neurological factors such as loss of sensation and foot deformity. legs, infections, osteomyelitis… Patients are treated with antibiotics, debridement to remove necrotic tissue, rotten plaque and fibrous tissue. The doctor evaluates the wound condition daily and weekly to adjust treatment methods if necessary. After a month, the wound developed granulation tissue, gradually healed, and Mr. Tung’s health stabilized.

The normal healing process has four stages including coagulation, inflammation, granulation tissue proliferation, epidermalization and restructuring. Dr. Hoang said that diabetics have metabolic disorders that cause the inflammatory stage to last from several months to two years, also known as chronic wound. Chronic wounds form from pressure ulcers, diabetic feet, the environment, skin damage from radiation, lymphedema, tumors… Patients who do not receive proper treatment risk serious infection and complications. symptoms, the leg must be amputated, which takes a lot of time and costs for treatment.

Doctors recommend that diabetics with wounds, especially on the feet, should see a specialist in endocrinology and diabetes for proper treatment.