Diabetic Foot Care: Treatment Options in Mumbai

The Growing Challenge of Diabetic Foot Complications

India is often called the diabetes capital of the world, with over 100 million people living with diabetes. One of the most serious and debilitating complications of diabetes is diabetic foot disease. Approximately 15-25% of people with diabetes will develop a foot ulcer during their lifetime, and without proper treatment, these wounds can lead to infections, gangrene, and ultimately amputation.

Dr. Prasanna Somvanshi, a board-certified plastic surgeon in Mumbai, plays a critical role in the management of diabetic foot complications. As a plastic surgeon specialising in wound care and reconstruction, Dr. Somvanshi offers advanced treatment options that can save limbs and restore function for patients with complex diabetic foot wounds.

Understanding Diabetic Foot Complications

Diabetes causes damage through several mechanisms that make the feet particularly vulnerable:

• Peripheral neuropathy – Nerve damage leads to loss of sensation in the feet. Patients may not feel injuries, blisters, or pressure points, allowing wounds to develop unnoticed.
• Peripheral vascular disease – Reduced blood flow to the extremities impairs wound healing and increases infection risk.
• Impaired immune response – Diabetes compromises the body's ability to fight infection, making even minor wounds potentially dangerous.
• Charcot foot – A condition where neuropathy leads to weakening and fracture of foot bones, causing severe deformity.

These factors combine to create a perfect storm where minor injuries can rapidly progress to serious, limb-threatening conditions.

Wound Assessment

Proper assessment of a diabetic foot wound is the foundation of effective treatment. Dr. Prasanna Somvanshi evaluates:

• Wound size, depth, and location – Documented and measured to track progress.
• Infection status – Signs of cellulitis, abscess, or osteomyelitis (bone infection) are assessed.
• Vascular status – Blood flow is evaluated using clinical examination and Doppler studies. Adequate blood supply is essential for healing.
• Neuropathy assessment – The degree of sensory loss is documented.
• Bone involvement – X-rays or MRI may be needed to rule out osteomyelitis.

Classification systems such as the Wagner classification and University of Texas classification help grade the severity of the wound and guide treatment decisions.

Treatment Options

Debridement

Removal of dead, infected, and non-viable tissue is the first step in managing diabetic foot wounds. Sharp surgical debridement performed in the operating theatre is often necessary for deep infections. Dr. Somvanshi performs meticulous debridement while preserving as much healthy tissue as possible, creating a clean wound bed that can heal or accept a graft or flap.

Wound Care and Dressings

Advanced wound dressings play an important role in creating an optimal healing environment. Options include:

• Foam dressings for moderately exuding wounds
• Alginate dressings for highly exuding wounds
• Silver-containing dressings for infected wounds
• Collagen-based dressings to promote granulation tissue

Negative Pressure Wound Therapy (NPWT)

Also known as VAC (vacuum-assisted closure) therapy, NPWT uses controlled suction to promote wound healing. It removes excess fluid, reduces bacterial load, increases blood flow, and promotes the formation of healthy granulation tissue. This therapy is particularly valuable for large or complex diabetic foot wounds.

Flap Coverage and Skin Grafting

Once the wound is clean and infection-free, definitive coverage may be needed. Options include:

• Skin grafts – Split-thickness grafts for superficial wounds
• Local flaps – Tissue rearrangement using nearby healthy tissue
• Regional flaps – Such as sural artery flap for heel and ankle defects
• Free flaps – Microsurgical tissue transfer for large, complex defects when local options are insufficient

Dr. Prasanna Somvanshi performs these advanced reconstructive procedures at hospitals across Mumbai, including SevenHills Hospital, HN Reliance Foundation Hospital, NH SRCC, MRR Hospital, Surya Hospital, and Sushrusha Hospital.

Prevention Is Key

Preventing diabetic foot complications is far better than treating them. Essential prevention strategies include:

• Daily foot inspection – Check for cuts, blisters, redness, and swelling
• Proper footwear – Wear well-fitted, protective shoes at all times
• Blood sugar control – Maintaining optimal glucose levels is the single most important factor
• Regular check-ups – Annual foot screening by a healthcare professional
• Avoid walking barefoot – Even at home
• Moisturise feet – Prevent dry, cracked skin that can become entry points for infection

When to Seek Help

If you have diabetes and notice any wound on your foot that does not heal within 1-2 weeks, shows signs of infection (redness, warmth, pus, odour), or if you experience new numbness or changes in foot shape, seek medical attention immediately. Early intervention can prevent progression and save limbs. Dr. Prasanna Somvanshi offers expert diabetic foot assessment and treatment in Mumbai. Contact his clinic today for a consultation.