Diabetic foot: the wound can be cured without amputation For diabetic foot, the traditional treatment method in China is amputation, and generally advocate high amputation below the knee. However, after the diabetic foot amputation, some patients still can not heal the amputation wound, and the limb damage to the patient and family members, psychologically unbearable, some would rather die than amputation. So, do these patients really need amputation? How do ulcers heal effectively? What can be done to cure the diabetic foot? Diabetic foot is currently on the rise due to the increase in the number of diabetic patients. When the lesion is severe or combined with infection, gangrene of the extremity is called diabetic limb gangrene, which is very disabling. Generally, a grade 3 to 5 diabetic foot is gangrene, which is characterized by deep infection of the foot with bone tissue lesions or abscesses, respectively. In this case, what should be done? To treat diabetic foot, we must take the principle of “four combinations”, otherwise which one is not in place, it may be ineffective or inefficient treatment. First, the synchronization of medical and surgical treatment: diabetic foot has a lot of medical manifestations, but also a lot of surgical manifestations. Internal medicine only cares about medication, while surgery only cares about wounds, which are disconnected from each other and cannot be promoted simultaneously. If the patient has a large wound, he may end up having to amputate only the leg. Only by combining internal medicine and surgery can the wound heal. Second, the overall and local synchronized treatment: once a diabetic patient has a foot ulcer, it is a local manifestation of the systemic lesion. If too much emphasis is placed on treating local wounds, little effect will be achieved. The Department of Traumatic Ulcer and Orthopedics is equivalent to the combination of internal medicine and surgery, and the overall treatment and local treatment are carried out in synergy, with remarkable efficacy. Third, Chinese medicine and Western medicine are synchronized: effective antibiotics are selected to control systemic and local infection of gangrene and prevent the spread of trauma and sepsis. At the same time, Chinese herbal medicines are taken internally or applied externally to clear heat and detoxify the body, invigorate blood circulation and remove blood stasis, and support the root cause in order to improve the body’s resistance, enhance the regenerative capacity of tissue cells, and promote wound healing. Fourth, treatment and prevention in parallel: diabetic patients, especially those with a medical history of 5 years or more than 10 years and a history of smoking, are at high risk of diabetic foot ulcers, and should usually take extra precautions. Control the three high, appropriate exercise, prohibit smoking and alcohol, taking skin disease bone Ning No. 2 and other agreements to reduce the Chinese medicine; corns, calluses, bone spurs, nail infections and cysts or tinea pedis, timely treatment; pay attention to foot warmth, wash feet and use electric blankets, hot water bags and other things for warmth, do not burn the feet; once the foot appeared small skin damage, timely treatment in the hospital. Play the “blood sugar control, decay, muscle” trilogy Take the “four combined” principle, and then according to the sugar control, decay, muscle three stages of treatment, without amputation, can be effective and save money to cure diabetic foot. Basic treatment stage: For severe gangrene, use effective antibiotics intravenous drip to increase anti-infection, and most patients need to control blood sugar with insulin. Intensify the blood circulation and remove blood stasis until the circulation is improved, and if necessary, interventions can be made to reopen the blood vessels. Control cardiac, renal, cerebral and other acute and chronic complications, improve anemia and hypoproteinemia. For wet gangrene, gradually remove necrotic tissue and maintain unobstructed drainage; for dry gangrene or bone destruction, do not treat prematurely and remove after the establishment of collateral circulation. Decomposition phase: premature complete debridement is not conducive to controlling the development of gangrene; too late debridement is not conducive to the growth of granulation tissue. The correct approach should be: in patients with wet gangrene, when blood glucose control is close to normal, local infection is reduced, related complications are controlled, and the general condition is basically improved, a nibbling approach should be taken to gradually remove necrotic tissue and ensure unobstructed drainage; in patients with dry gangrene or partial blackening of the toe, after the blood supply to the extremity is improved, local inflammation is reduced, and the demarcation between dry necrosis and healthy tissue is clear, the toe can be removed from the base of the toe. The base of the toe can be excised. Myogenic stage: Patients who have been bedridden for a long time and are in poor physical condition need to go through a longer period of basic treatment and decay treatment stage. If the granulation is not fresh and the pain is obvious, we can use the external application of Skin Disease Bone Nurse No. 6, or use VSD artificial skin to promote the growth of granulation, choose the time to transplant the skin flap, or choose stem cell transplantation to promote the establishment of collateral circulation and the growth of granulation, and give external Chinese medicine to make the wound heal.