DR. ASHISH GUPTA

Friday, January 3, 2020

7 TIPS FOR WINTER DIABETIC FOOT CARE

7 TIPS FOR WINTER DIABETIC FOOT CARE

Winter brings its own set of problems for patients suffering form diabetes. Burns due to hot water, heater, electric blankets and radiant heaters cause additional woe for the patient. We give you seven steps to safety to keep your feet happy.

1. Keep your feet DRY:

When it comes to your feet, rain, snow and slushy weather have something in common: they cause dampness. Moisture that collects between your socks and your feet and toes can form bacteria, which can lead to an infection.

Keep your feet dry and pay special attention to the areas between your toes.

2. Avoid Direct Heat to your Feet:

Diabetic patients have numbness and they may not feel when their feet are burning.

They can sustain second or third-degree burns, which can cause serious foot problems.

Patients with diabetes should not put their feet in hot water.

They should test bath water with their hands or a thermometer first.

Avoid using warming aids on the feet, such as electric blankets, heated shoe inserts and heating pads.

3. Moisturize your feet:

Use a moisturizer daily to keep dry skin from itching or cracking.

Do not moisturize between the toes--that could encourage a fungal infection.

Patient should be careful if he/she observes red shiny areas on their feet, this is a warning sign that the skin will form an ulcer.

4. Get the RIGHT SHOES:

Patients with diabetes should wear well-fitted shoes with supportive soles and a wide toe box to reduce cramping.

During the colder seasons, extra thought should be given to sock texture and how the weather will affect walking conditions

5. Trim Those NAILS :

Untrimmed or infected toenails are a frequent cause of infections and ulcers.

You can soak your feet first to soften the nails and then cut them straight across.

If you have trouble trimming your nails, get help.

6. Keep Blood Sugar Under Control:

Your feet absorb a lot of the daily wear and tear of your body

They are one of the first places poor diabetic control will show up.

7. Visit your Plastic Surgeon Regularly:

Work with your doctor to control your sugar and be sure to watch your diet, maintain your weight, exercise regularly, and avoid smoking.

Your feet will thank you!!!!!

DR ASHISH GUPTA
Senior Consultant
Dept. Of Plastic & Microvascular Surgery
S.P.S. Hospitals, Ludhiana
+91-977977-1111

Monday, December 2, 2019

SCAR WARS: MYTHS AND SOLUTIONS

Scar Wars: Myths and Solutions

Anyone who remembers his or her childhood would remember their falls, skids and skirmishes that left behind the tell tale signs we call SCARS. He or she has equal number of vivid stories to narrate with them. Some of the most common queries regarding scars are answered here.

Myth No.1: How many sutures will be put on the wound?

Answer: Scars do not depend on the number of sutures. Rather a thicker suture causes more scarring than a fine suture. Even though there are more stitches with the fine thread, they can be removed earlier leaving behind an insignificant scar.

(SUTURED WITH A THICK THREAD: TRAM TRACK SCAR)

Myth No.2: Sutures cause scarring of the wound.

Answer: Suturing a wound brings cut ends of skin together helping it heal faster. Any wound that takes less than 2-3 weeks to heal leaves a fine scar. We usually remove the sutures within 5-7days to prevent scarring.

(SUTURED WITH A FINE THREAD: NEARLY INVISIBLE SCAR)

Myth No.3: Dissolving sutures do not cause scarring

Answer: Dissolving sutures (absorbable sutures) are usually used to close the inner layers of the wound to prevent stretching of the scar. On the skin they can be used as a sub-cuticular (under the skin) stitch in a clean wound with healthy margins. When dissolving sutures are applied as normal sutures on the skin they may dissolve early in infection and the wound may gape open; or they may dissolve late and leave behind suture track scars.

Myth No.4: Glue is better than suturing and leaves no scars

Answer: Tissue glues are used in wounds that are well approximated (not gaping open). The scar shall depend on the approximation of the skin, the depth of the wound and site (immobile areas). If applied in a gaping wound, it tends to coat the wound edges and does not allow it to heal until the glue is scrapped off. Glue usually complements the suturing but not as a substitute.

(Note: No financial disclosures)

Myth No.5: Wounds left open dry faster

Answer: Superficial wounds like abrasions are left open with topical antibiotic creams and they usually heal within a week. Deep wounds like deep abrasions, contaminated wounds (dirt & debris), lacerations on hands, feet and face need to be sutured and dressed for early healing and better scaring. Scar depends on the extent of tissue loss and time taken for the wound to heal not if it was left open.

Myth No.6: Sunlight fades the scars

Ans: There’s nothing about tanning that’s healthy for your skin. UV rays lead to hyperpigmentation (make the scar darker). One should cover the scars with sunscreen with at least SPF 30—or better yet, covering with (white) clothing—to help the scars continue to fade and blend in.

Myth No.7: Scar creams make scars disappear

Answer: It is untrue. Multiple advertisements and scar creams claim to make the scar disappear. Once a scar, always a scar. We can improve the quality of the scar with these creams, make them lighter, with massage make them softer and with plastic surgery (techniques) and lasers hide them in the normal skin creases. But cannot make them disappear totally.

Myth No.8: Why revisit the plastic surgeon once the wound has healed?

Answer: Scars undergo numerous changes in the first 3 to 6 months in their colour, texture, size, height and feel. Reciprocally, equal number of interventions need to be done at appropriate time to get the best results whether you got stitches or left the wound to heal by itself.

DR. ASHISH GUPTA

SENIOR CONSULTANT PLASTIC SURGEON

S.P.S. HOSPITALS, LUDHIANA

+91-977977-1111

DOCASHISH2001@GMAIL.COM

Saturday, October 26, 2019

CELEBRATE A SAFE DIWALI

Once upon a time there was a house in Ludhiana, where lived, Avyukt and Anika. It was the auspicious night of Deepavali when all were getting ready for the celebrations of the festival of lights. Avyukt changed from his beautiful Kurta Pyjama into a smart pair of jeans and shirt and he told Anika “Do not wear loose clothes as they can catch fire from the candles and the firecrackers.”

They both sat down with their parents for the pooja and Anika grabbed the box of matches and put it in her pocket with a string of firecrackers in her other pocket. Avyukt told her that Children should not play with fire or they can get hurt and she Should not keep firecrackers in her pocket as they can go off causing her injury.

Once the Pooja was over, their mother told them to take the thali of Diyas and keep one in every dark corner of the house. Anika was enthralled by the glittering light of the diyas and wanted Avyukt to keep one in her room next to her teddy bears. Avyukt said, “No we shall Not keep burning diyas in the room as the curtains and soft toys can catch fire.”

After keeping all the diyas around the house Anika was excited that she will get to burst crackers with her elder brother under the watchful eyes of their parents. Avyukt got all the crackers and kept them in a room away from the candles. Then he got two buckets and a tall wide base bottle. Anika was surprised why he is doing that and asked him. Avyukt said, “One bucket I’ll keep in the corner where we will discard all the sparkles once they are done and the other I will fill up with water so that if anything catches fire I can pour the bucket of water over it to douse the fire. The bottle is for the rockets that I will fire up with a phooljhari (sparkle) from a safe distance.”

All this while Anika was holding an Anaar (Flowerpot) in her hand and as soon as she got hold of a Phooljhari she started to light it up. Avyukt suddenly shouted, “No lighting the crackers in your hand. If they burst they will cause a lot of injury.”

Anika was enthralled by the beauty of the Chakkri and started jumping across it when she got reprimanded again. Exasperated, she said, “How can I have any fun when you don’t let me do anything.” Avyukt said, “You can burn your feet and your dress from the sparkles that come out. See even our great grandfather is wearing shoes while sitting on the chair because he has diabetes and he cannot feel his feet. He will not know if they get burnt, that’s why he is wearing shoes. ”

She said, “Is there anything else also you need to tell me?” Avyukt replied in a somber voice, “Always be aware of your surroundings. Be careful that someone may be lighting a cracker behind you. Avoid putting boxes over lit bombs as they become projectiles when the bomb goes off.”

As the penultimate phooljhari was about to go off a few maverick sparkles fell on Anika’s hand and she cried out in pain. Avyukt called out for help and put her hand under running tap water. The Maid, who was on her phone the whole time, suddenly realized that something bad had happened and rushed to get toothpaste to sooth her pain. Before she could apply it, their parents came up. Her mother removed Anika’s bangles and rings which could cause more pain when the swelling would set in and her father got her painkiller syrup to ease her pain. While his mother was comforting Anika with a local anaesthetic gel, Avyukt asked his father, “If her clothes had caught fire, then what should have I done dad?”

Seeing his concern and curiosity his father replied, “If anything like that happens, Do Not Run. Best thing is to Stop, Drop and Roll. Pour water to douse the fire and remove all the burnt clothes to stop the burning process and cover the patient in a clean sheet. Do not apply toothpaste, mehndi or haldi on the burnt area because when it dries it causes even more pain and the risk of infection becomes high. It is necessary to Consult a Plastic Surgeon for treatment and further course of action so that later there are no scars.”

By the time his lesson on First Aid in Burns was over, Anika was already clamoring for the last phooljhari before her brother could get to it. With a coy smile she said, “Main Choti Hun Na!!” (I am your younger sister, ya)

HAVE A SAFE AND A HAPPY DIWALI