Diabetic Foot Care

Dear Editor:

I read Dr. Galvin’s column on diabetic foot ulcers with great interest.

Having spent many years as a general surgeon practicing wound care and hyperbaric medicine, I agree with almost everything that he wrote. However, there is one point with which I must take exception. Dr. Galvin wrote that bones do not have a blood supply. But, in fact, they do. There is a blood supply present via the periosteum or outermost layer of bone, and there are other nutrient arteries present as well. All cells require oxygen to live and perform their functions, and bone cells are no exception. Without an oxygen supply, fractures would not heal, and bone infections would not respond to antibiotic therapy. Hyperbaric oxygen therapy is used very frequently for the treatment of osteomyelitis, and this therapy works by increasing the concentration of oxygen in the blood that is delivered to bones via their arterial supply.

It is absolutely important for diabetics or anyone with a neuropathy to be very diligent about foot care. It is also imperative that primary care doctors and other health care deliverers pay close attention to the neuro – vascular status of their elderly and diabetic patients.

Burton J. Glass MD FACS