Do moxibustion at home, and in just 5 days, the wound turned into ulceration on the whole leg! To prevent diabetic foot, pay attention to the little things in life

"Director Li, long time no see! I have recovered well. I came here from my hometown by train today!" Some time ago, Ms. Liu came to the Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine for a follow-up examination and went straight to the clinic of Chief Physician Li Hongye of the Orthopedics Department.

Seeing Ms. Liu walking freely, Li Hongye couldn't help but think of the first time he saw her more than three years ago - she was sitting in a wheelchair and was pushed into the clinic by her family. Her face was gray and her eyes were dull. She kept asking like a drowning person grasping at the last straw: "Can I save my legs?"

4 surgeries, 3 toes amputated

Still can’t save the left leg?

Ms. Liu, who is over 50 years old and has been suffering from diabetes for more than 10 years, relies on insulin injections to control her blood sugar. As time goes by and she feels no obvious discomfort, the "string" in Ms. Liu's heart gradually loosens, and it seems that diabetes is not that scary. With intermittent insulin injections, poor oral control, and unwillingness to exercise, Ms. Liu's blood sugar often remains high.

Four years ago, Ms. Liu suddenly found a small wound on the second toe of her left foot. "It's only this small, and it will heal on its own in a couple of days."

What happened next was beyond Ms. Liu’s expectations. The wound expanded, festered, and began to ooze pus. Even the nearby toes were “infected”… More than a month had passed before she realized the seriousness of the problem.

Ms. Liu went to a local doctor in her hometown and was diagnosed with diabetic foot. The doctor told her that she needed to amputate her toe. This was no less than a bolt from the blue, but the reality left her no choice but to rush the operation.

Unfortunately, the postoperative recovery was not smooth. As the wound was difficult to heal, Ms. Liu's condition further deteriorated. Her family accompanied her to the north to seek medical treatment. They went to many hospitals and spent more than 200,000 yuan. She underwent 4 operations including small amputation, debridement, repair, and vascular balloon dilatation. The second, third, and fourth toes of her left foot had been amputated, leaving only the big toe and the little toe. However, Ms. Liu's limbs were still further necrotic, and dark brown and purple patches appeared on her left leg, gradually connecting into pieces - this is a typical diabetic pretibial lesion, indicating that there are serious problems with the blood vessels in the calf. At the same time, the pain made it almost impossible for her to sleep. Many tertiary hospitals in Beijing believe that only calf amputation can be performed.

An orthopedic expert in Beijing told Ms. Liu that the Zhejiang University Run Run Shaw Hospital in Hangzhou is the best in the country in the diagnosis and treatment of diabetic foot. If she doesn't want to give up, she can go there and give it a try.

Surgical debridement + application of original technology

Her left leg was saved!

"The patient and her family came with the mentality of 'give it everything we have'. They said that this was their last gamble, and if our answer was also amputation, they would go back to their hometown for the surgery. They were going to lose their legs anyway, so it didn't matter where they went." Li Hongye recalled that Ms. Liu's family were in a very negative mood when they received the consultation.

After receiving Ms. Liu, the Diabetic Foot Disease Diagnosis and Treatment Center of Zhejiang University Shaw Hospital, which is composed of multiple disciplines such as orthopedics, endocrinology, vascular surgery, ostomy and difficult wound specialists, and plastic surgery, took immediate action to evaluate and discuss her condition.

"We decided to first perform surgical debridement on the patient, remove necrotic tissue and repair it, and then use the nanovesicle technology with independent intellectual property rights in orthopedics to promote wound recovery. If the wound can recover, the patient can walk independently as soon as possible, and the collateral blood vessels in the lower limbs will gradually grow back on their own, the probability of avoiding amputation will be greatly increased." said Li Hongye.

Fortunately, after a series of treatments, Ms. Liu's condition was under control! As the wound healed, Ms. Liu was able to try to walk, and finally, her left leg was saved!

Multidisciplinary collaboration

Limb salvage rate greatly improved

At present, the annual number of patients with diabetic foot wounds at the Zhejiang University Run Run Shaw Hospital Diagnostic and Treatment Center has reached tens of thousands, and more than 90% are diabetic foot patients referred from within the province or even across the country, as well as long-term follow-up patients. According to statistics, less than 20 patients ultimately required amputation throughout last year.

"The improvement in limb salvage rate is due to many factors. First, people have paid more attention to diabetic foot in recent years. Early diagnosis and early treatment will lead to better prognosis. Second, our diabetic foot diagnosis and treatment center is a multidisciplinary team for joint diagnosis and treatment. The treatment process is constantly optimized. Compared with the previous consultation system, as long as the patient comes to the hospital, all disciplines are seamlessly connected, saving the patient from wasting time on switching departments. After all, for diabetic foot patients, time is limbs."

Li Hongye also mentioned that, taking orthopedics as an example, bone cement technology and nanocapsule technology are currently the most widely used in diabetic foot patients. "In the past, bone cement was mostly used in surgical treatment of limb bone infection, but our hospital is at the forefront of using it in the treatment of diabetic foot worldwide. In addition, the difficulty in healing lower limb ulcers and the infection of diabetic foot patients have always been clinical difficulties and pain points, and our orthopedic team has innovatively proposed the concept of '70% fullness of inflammatory cells' internationally, so that inflammatory cells cannot absorb more nutrients, thereby reducing wound inflammation and promoting ulcer repair and healing." Based on this concept, the orthopedic team independently developed nanocapsule technology, which has been widely used in the treatment of various types of diabetic foot and chronic refractory wounds, and many patients have benefited from it.

Just five days

From a small wound to the entire left leg festering

Li Hongye introduced that diabetes may bring hundreds of complications, but diabetic foot is definitely the one that doctors are most reluctant to see. The speed of progression of diabetic foot may be far beyond your imagination. It sometimes only takes a few days for a small wound to develop into a leg ulcer.

More than a month ago, Li Hongye received a 47-year-old female patient who had suffered from diabetes for many years. Hearing that moxibustion was effective for back pain and leg pain, she bought moxibustion equipment online and did it at home. She did it all over her waist and legs. Due to improper operation, she accidentally burned a small part of her left leg when moxibustioning, but she didn't pay attention to it at the time.

Five days later, the patient was sent to the emergency department of Zhejiang University Run Run Shaw Hospital due to ulcers on his left leg and high fever all over his body.

"After examination, the patient was diagnosed with diabetic foot necrotizing fasciitis. All the muscles in her left leg were necrotic. At the same time, due to severe Pseudomonas aeruginosa infection, her entire left leg was green when she was admitted." Li Hongye said that the condition was very serious and in order to save her life, she had to undergo a hip dissection of her entire left leg. "The patient's family conditions were already very poor. She stayed in the ICU for more than three weeks, and her vital signs were still unstable. Even if she survived this time, her quality of life in the future would probably be very poor. In the end, the family voluntarily gave up and took the patient home."

Prevention is far better than cure!

Start with the small details in life

Diabetic patients themselves have a slow pain response and cannot feel pain when their skin is broken. They also have poor resistance and infection resistance. High blood sugar can easily lead to poor wound healing. Therefore, the prevention of diabetic foot is far more meaningful than treatment.

How to prevent diabetic foot? Li Hongye gave some suggestions:

1. Shoes are very important. Don't wear pointed shoes, wear less cloth shoes, change shoes frequently to avoid always putting force on one place;

2. Be careful when cutting toenails, leave a little space and don't cut too deep, as it may cut the flesh.

3. Wear light-colored socks. Diabetic patients have a weaker sense of pain. When wounds or bleeding occur, wearing light-colored socks can help detect them in time.

4. Apply moisturizer to your feet in autumn and winter to prevent dryness and cracking;

5. Use your elbow to test the temperature before soaking your feet. The duration should be controlled within 15-20 minutes.

6. After being diagnosed with diabetes, it is recommended to screen for complications every year for early detection and treatment.

Metropolis Express·Chengshi Interactive reporter Zhang Huili and correspondent Li Wenfang