Why Diabetic Wounds Are Different

  • Elevated blood sugar impairs wound healing at multiple levels
  • Peripheral neuropathy reduces sensation, delaying detection
  • Peripheral arterial disease reduces oxygen and nutrient delivery
  • Immune function is often impaired
  • Infection risk is significantly elevated
  • Small wounds can progress rapidly to major tissue loss if not addressed

Standard wound care that works for non-diabetic patients often falls short in diabetic wounds.

Our Programme

Comprehensive Initial Assessment

  • Wound assessment (size, depth, tissue quality, infection status)
  • Blood sugar assessment (HbA1c, current glycaemic control)
  • Vascular assessment (pulses, ankle-brachial index where indicated)
  • Neurological assessment (monofilament testing, sensation)
  • Nutritional assessment
  • Infection culture and sensitivity
  • Imaging (X-ray for osteomyelitis suspicion)

Coordinated Diabetes Management

Blood sugar control is foundational. We coordinate with the patient's diabetologist or physician to optimise glycaemic control alongside wound care. Where a patient does not have current diabetes care, we can guide to appropriate physician.

Wound Care Protocol

  • Modern debridement (mechanical, enzymatic as appropriate)
  • Appropriate dressing selection based on wound stage
  • Negative pressure wound therapy where indicated
  • Ayurvedic topical applications (medicated oils, ghrita, powders) for select wound phases
  • Infection management with appropriate antibiotics

Jalauka (Leech Therapy)

For select diabetic wounds with venous congestion or stagnation, Jalauka is a valuable adjunct.

Offloading

For plantar wounds, appropriate offloading (footwear modifications, offloading devices) is essential.

Nutritional Support

Adequate protein, vitamins, and micronutrients for wound healing.

Referral Coordination

Cases requiring vascular surgery, plastic reconstruction, or higher-level intervention are referred appropriately.

Prevention

For diabetic patients without current wounds, prevention includes:

  • Daily foot inspection
  • Appropriate footwear
  • Blood sugar control
  • Regular podiatric review
  • Prompt attention to any foot injury

We provide prevention counselling for diabetic patients.

Realistic Expectations

Diabetic wounds have failed to heal for reasons that require addressing. Meaningful progress typically takes 2 to 4 months, sometimes longer for very chronic wounds. Consistency of care and blood sugar control determine outcomes as much as the wound care itself.