Dr. Jordi Asunción is an orthopedic surgeon, specialist in Foot and Ankle Surgery, with extensive and proven experience in the treatment of foot pathology and more specifically in the pathology of diabetic foot.. He is currently the Coordinator of the Foot and Ankle Unit of the Hospital Clínic of Barcelona, where different Courses and Conferences are held annually for training in this specialty.. It also coordinates the Diabetic Foot Unit of this hospital formed by a multidisciplinary group of prestigious specialists in this field.
Dr. Jordi Asunción, could you explain what diabetic foot is?
Diabetic patients tend to have foot problems secondary to the neuropathy and vascular disease they develop, all these problems that occur in the foot of a diabetic person are called "diabetic foot". Among the different pathologies, it is the plantar ulcers that suppose an increased risk of suffering serious complications that may lead to infection and amputation of the limb, which is a serious injury to the patient.
How should a diabetic foot be treated?
The treatment of the diabetic foot is aimed at preventing amputation of the foot, maintaining a useful and functional limb, using different orthopedic and surgical procedures, ranging from the use of support insoles and appropriate footwear to the most complex surgeries such as the arthrodesis. A very important role in this process is the treatment of plantar ulcers, different resources must be used for its definitive cure, being the shock wave therapy an excellent alternative for this, being able to be associated in addition to other conventional treatments.
What effects do shock waves have on diabetic foot ulcers?
Electrohydraulic shock waves are applied on the skin ulcer producing an induction effect for the regeneration of the collagen tissue causing a release of growth factors that favor the appearance of new blood vessels and the proliferation and differentiation of the fibroblasts, which translates as a stimulus that favors the healing of soft tissues. In addition, shock waves have a bactericidal effect because they also destroy the bacteria that are contaminating the ulcer, thus avoiding a possible secondary infection.
How is this treatment done?
This treatment is performed on an outpatient basis in the medical consultation, without requiring any type of anesthesia because it is completely painless, there is no type of contraindication to be able to perform this procedure and no side effects or undesirable. It is necessary to have a machine that emits electrohydraulic shock waves specifically designed for the treatment of this type of lesions (such as the Dermagold 100 that we have at our center) that are applied directly to the skin ulcer on which a sterile transducer gel is placed to avoid contamination. The amount of shock waves that must be applied in each case will depend on the size and depth of the skin lesion, that is, larger size will require more shock waves, repeating the treatment every two weeks until complete healing of the ulcer.
How long does it take to finally cure the ulcer?
Naturally, this will depend on the size of the lesion we are going to treat, but in a general way we could say that it usually goes from 3-5 sessions in minor injuries to 10-12 sessions for large ulcers.