High blood sugar with severe and chronic fluctuations over time (usually about 15 years) leads to capillary destruction, especially in the lower extremities (legs). The main pathology of diabetic foot syndrome is capillary destruction (microangiopathy). Therefore, to deal with the spread of diabetic foot ulcers and also its treatment, treatment management is recommended according to the following procedure:
- Determining the degree of capillary destruction (circulatory failure) caused by diabetes
For this purpose, the method of monitoring the amount of tissue oxygen through the skin or TransCutaneous Oximetry Monitoring (TCOM) is used. In this method, the oxygen pressure in the tissue is measured. Tissue oxygen levels are a reliable reagent for determining capillary volume in tissues under study. This makes it possible to monitor capillary disorders. - Treatment based on TCOM test results
2-1- In the absence of capillary disorders, wounds can be treated with antibiotics, debridement, appropriate dressings, etc. (Conventional Therapy)
2-2- In the presence of capillary problems, tissue oxygen deficiency occurs. As a result, it is not possible to deliver the drugs needed to control the infection to the wound site. Therefore, it is necessary to provide an oxygen-rich environment (which is necessary for the reproduction of capillaries) by using hyperbaric oxygen therapy (HBOT). Under these conditions, capillary regeneration is encouraged. (MicroAngiogenesis) - Simultaneously with diagnostic procedures (TCOM), supportive wound treatments including antibiotic therapy, debridement, phototherapy and laser, special dressings, etc. will begin and continue.
It should be noted that this method (TCOM) is used in other diseases that are associated with capillary destruction, such as Buerger's disease.