Hospitals. Great big structures filled with corridors, rooms, medical equipment and caring healthcare professionals. While we all have our own experiences with family or friends being in the hospital, you may not realize the types of things that bring a podiatrist into a hospital. Most care provided by podiatrists is outpatient – meaning that the visits are performed in clinics or medical offices. However, hospitals are busy with patients who have foot related ailments that require hospitalization.
The most common reason that we see patients in the hospital is due to infections. This can be something like a diabetic patient with an ulceration, but also can be from something as simple as a case of athelete’s foot gone terribly wrong. Infections in the foot can spread quickly in the case of a patient with diabetes. If blood sugars are poorly managed, it affects our body’s ability to fight infections and to heal. A small cut on the toe after a pedicure can become an infection that affects the underlying bone in a matter of days for some.
When infections first begin, they start in an area that bacteria has entered the skin and the number of bacteria present increases in number. Our body’s immune system sends blood flow and healing cells to the infected area and tries to gobble up the bacteria to neutralize the infection. If our immune system is compromised (which happens for a lot of reasons) the infection may overcome our body’s defense system and spread to deeper areas of the body. If this gets really out of hand, infection can spread into the blood stream causing sepsis. Antibiotics taken by mouth and started early have a great opportunity to cure the infection. Cases where this may not work well is if there is poor blood flow or circulation to the affected area. Oral antibiotics are processed through our digestive tract before entering the blood and the blood then has to get to the infection.In severe infections, especially those suspected to be in the bone, intravenous antibiotics have greater efficacy against infections. However, infections that are not promptly treated can cause enough damage that removing the affected bone and tissue (an amputation) is the best option for protecting the rest of the body from the spread of infection.
Signs of infection include pain, swelling, redness, open sores, drainage or bad smell from a body part, fever, chills, nausea and vomiting. Not all of these signs have to be present to mean that there is an infection. In diabetic patients, pain is often the missing factor and the reason for delayed treatment. If it doesn’t hurt – where is the urgency for having it looked at? Don’t ignore these signs. Seeing a podiatrist as an outpatient as soon as these symptoms arise decreases the need for a hospital admission as well as any need for surgery.