Diabetes: Small diabetic foot burns can cause big problems

Patients with diabetes have an increased risk for foot burns, and once a burn occurs, the morbidity and mortality is quite high, it was said at the annual meeting of the American Burn Association. A patient might sustain a foot burn without being aware of the injury because of impaired sensation in the feet. Insensate feet lead to prolonged exposure and deeper burns. Walking on hot surfaces, soaking in hot water, and even car heaters can cause foot burns.

You don't feel the pain after soaking your feet for a half-hour, and that leads to the problem. This is a duration-of- contact problem. The neurovascular changes associated with diabetes might also lead to impaired burn wound healing. It was said by a professor and chief of burn surgery, University of California Davis Medical Center, Sacramento that impaired healing leads to higher graft loss and an increased risk of amputation.

It was describe in its own experience treating small foot burn cases, including a patient with insensate feet who had been admitted for walking on hot asphalt, which resulted in trasmetatarsal and below-knee amputations. Another patient who had insensate feet returned home from a walk over hot rocks at a river bed to discover blood oozing from his feet. After lengthy treatment, four of the patient's toes had to be amputated. This is not only a disease that leaves a scar, but a disease that won't heal. These are high-risk patients and once you have a wound, it can lead to a cascade of events. One minute they've got a patient with ulcers between the toes, the next they're sticking a hemostat up their foot draining pus out of their plantar, and then they're doing a below-knee amputation.