I-Diabetic Foot Ulcer: Izimpawu, Izimbangela, Izigaba, Nokwelashwa

Isifo sikashukela yisifo esingelapheki esithinta izigidi zabantu emhlabeni jikelele. Phakathi kwezinkinga zesikhathi eside ezihambisana nesifo sikashukela esingalawuleki noma esingalawulwa kahle izilonda ezinyaweni, noma izilonda ezivulekile ezivame ukwenzeka phansi ezinyaweni.

Isigaba sokuqala sesilonda sesifo sikashukela singaqala sisincane kodwa singatheleleka uma singelashwa. Uma ukutheleleka kusakazeka kungaholela nasekunqunyweni kwendawo ethintekile noma ngisho nokufa ezimweni ezimbi kakhulu. Izilonda ezinyaweni zesifo sikashukela ziyavikeleka futhi ziyelapheka uma zitholwe kusenesikhathi futhi ziphathwa ngendlela efanele.

Izimpawu Zesifo Sonyawo Lwesilonda Sikashukela

Labo abanesifo sikashukela kufanele bahlole izinyawo zabo njalo ukuze babone noma yiziphi izimpawu zokuqala zezilonda noma izilonda. Izimpawu ezijwayelekile okufanele uzibheke zihlanganisa:

• Izinguquko kumbala wesikhumba noma ukuthungwa, okuhlanganisa ububomvu, amabhamuza, ukusikeka, ama-calluses, noma ukuvuvukala okungavamile
• Ukuba khona kwanoma yimuphi umswakama, ukukhishwa okuphumayo, noma iphunga elibi
• Ukulahlekelwa umuzwa noma ukungabi namandla ezinyaweni ezibangelwa ukulimala kwezinzwa (i-neuropathy)
• Ukuluma, ubuhlungu bokudutshulwa, esivuthayo, noma okunye ukungaphatheki kahle ezinyaweni

Uma kwenzeka noma iyiphi yalezi zimpawu, tshela udokotela wakho ngokushesha ukuze aphinde ahlolwe futhi athole ukunakekelwa okukhethekile ukuze welaphe izilonda ezikhona futhi uvimbele ukuqhubeka kwazo.

Izimbangela Zesifo sikashukela Sonyawo Isilonda

Kunezici ezimbalwa eziyingozi eziphakamisa amathuba okuba nezilonda ezinyaweni kulabo abanesifo sikashukela:

• Kubi likashukela egazini ukulawula isikhathi eside kulimaza izinzwa nemithambo yegazi, kunciphisa ukuzwa nokujikeleza ezinyaweni. 
• Ingcindezi eyengeziwe noma ukungqubuzana ezinyaweni okuvela ezicathulweni ezingafanele noma umthelela ophindaphindayo. 
• Ukusikeka okuncane, amabhamuza noma ukucasuka okunganakiwe futhi kutheleleke ngenxa yokuncipha kokuzwa ekulimaleni kwezinzwa.
• Ukuhamba okulinganiselwe ezinyaweni nasemaqakaleni kwenza kube nzima ukuhlola izinyawo njalo. 
• Ukushintsha ukuma kwezinyawo, ukukhubazeka kwezinzwane ngenxa ye-neuropathy kungaholela ekucindezelweni okuphezulu ngaphansi kwezindawo ezithile zezinyawo okuholela ku-callus kanye isilonda
• Ukungagcini amazinga kashukela egazini elawulwa kungaba nomthelela omkhulu amathuba okuba nezinkinga zemizwa kanye nezinkinga ezinyaweni.

Izigaba Zokuqala Zesilonda Sonyawo Lwesifo Sikashukela

Izilonda ezinyaweni zesifo sikashukela zikhula ngezigaba eziyisithupha ezichaziwe ezibonisa izimo eziba zimbi kakhulu. Izigaba zokuqala zinikeza iwindi elibalulekile lapho ukwelashwa okusebenzayo kusengahlehlisa umonakalo owenziwe.

Isiteji 1: Unyawo lubonakala lujwayelekile futhi lunempilo ngaphandle kwezinguquko ezibonakalayo zesikhumba noma amanxeba. 

• Noma kunjalo, izinkinga zemizwa zingaqhubeka buthule. 
• Izivivinyo ze-podiatry zisiza ukuthola izinkinga ezivelayo. 
• Iziguli kufanele zifunde futhi zisebenzise ukuhlanzeka okufanele kwezinyawo nokunakekelwa kwezinzipho.

Isiteji sesi-2: Ukulimala kwezinzwa nokungahambi kahle kwegazi manje kubonakala ngokuhlolwa nokuhlolwa, kodwa asikho isilonda esesike saba khona. 

• Isiguli sisebenzisana eduze namaqembu ezokwelapha ukuze kuvikelwe izinyawo eziyingozi kakhulu ngokuqapha ngokucophelela amanxeba, ukulungisa izicathulo kanye nomsebenzi ongabangela ukulimala kwesikhumba. 
• Ukufakwa okusekelayo noma izicathulo zamathambo zangokwezifiso zingase zilingane. 
• Ingxoxo yokuthi ungazihlola kanjani izinyawo zakho ifanelekile.

Isigaba 3: Inxeba elincane esikhunjeni livulekile, eliqala ngesilonda. 

• Izingubo zokugqoka amanxeba, kwemithi elwa namagciwane futhi ukuphumula kusetshenziswa ngokushesha ukuze kuphole futhi kuvimbele ukutheleleka. 
• Ukulayisha amanxeba ngenani eliphelele lokuxhumana noma elikhiphekayo knee i-high walker ingasetshenziswa. 
• Ukuphakama kwezinyawo eziqinile nokuphumula izinkathi vumela ukuhlolwa kwesilonda okuthembekile. 
• Isiguli kufanele sibike noma yikuphi ukungaphatheki kahle noma izinguquko ngokushesha njengoba isifo sonyawo lwesifo sikashukela singakhula ngokushesha. 
• Lapha, odokotela kufanele bagcine zonke izikhathi zokwelashwa, ngisho nokuhlolwa kwesikhashana ukuze balungise izithiyo kusenesikhathi.

Isiteji sesi-4: Indawo yesilonda iba yimbi, ukuvuvukala nokuphuma komchamo kukhomba ukutheleleka ngebhaktheriya okujulile okudinga ukulaliswa esibhedlela. 

• Imithi elwa namagciwane efakwa emthanjeni ilwa nokutheleleka okubhebhethekayo kuyilapho umsebenzi walebhu ukhomba isidalwa esihlaselayo ukuze sihlanganise ukwelashwa. 
• Ukuhlinzwa kususa izicubu ezifile ukuze izicubu ezinempilo zigcwale isilonda imibhede. 
• Isiguli sinciphisa umsebenzi okwesikhashana ukuze siphumule izinyawo kuze kube yilapho ukuvuselelwa kweseli kusiza ukwenza isilonda esiyinkimbinkimbi sibe sijwayelekile. 
• Noma yikuphi ukubambezeleka kungasho ukuphinda ukusebenza noma ingozi yokufa.

Isiteji sesi-5: I-Gangrene, noma izicubu ezinyaweni ezifile zivela eduze kwezilonda, ngokuvamile ezivela ezifweni ezingalashiwe ezivela ekunganyakazini kanye nokulawulwa kabi kwe-glucose ngokuhamba kwesikhathi. 

• Ukulaliswa esibhedlela, imithi elwa namagciwane, nokuhlinzwa kuhloswe ukuba kukhishwe izicubu ezifile, nakuba isiguli kumelwe sivumelane ukuze kusale isilonda esithile. 
• Ukuphakama kwezinyawo eziqinile nokuphumula kuyaqhubeka kanye nokuyeka ugwayi. 
• I-prognosis ibonakala ibuhlungu uma izilonda zingabonisi ngcono.
• Ukuhlolwa kokunikezwa kwegazi onyaweni, ukuthuthukisa ukutholakala kwegazi ngesikhathi nangesikhathi kunesiqinisekiso somtholampilo kubaluleka ekulawulweni kwanoma yisiphi isilonda sezinyawo ezinesifo sikashukela.
• Inqubekelaphambili ilingana nezingozi ezikhulayo - iziguli ezikwazi ukubona izimpawu zangaphambi kwesikhathi zibekwe kangcono ukuze zivikele ukuhamba kwazo kukonke, amandla, nempilo ende. 

Lokhu kudinga ukuqonda izigaba ezicashile ngenkathi usamukela imikhuba nemikhuba ebeka impilo kuqala. Xoxa ngokukhathazeka, izinguquko noma ubuhlungu nodokotela ngokushesha - ukubambezeleka kungashintsha kakhulu imiphumela ngakho-ke qaphela. 

Ikusasa lakho lempilo yonyawo lihlala, okungenani, lingaphakathi kolawulo lwakho ngokulalelisisa, ubunikazi bendlela yokuphila, kanye nesinyathelo esiwujuqu lapho kuvela izimpawu zokuqala zezilonda. 

Ukwelashwa

Uma kukhonjwa isilonda sonyawo lwesifo sikashukela, izindlela zokwelashwa ezijwayelekile zihlanganisa:

• Ukuhlanzeka kwamanxeba ngokucophelela nokuguqulwa kwamabhandeshi ukuze kube lula ukuphola
• Ama-antibiotics uma ukutheleleka ikhona
• Ukukhipha noma yiluphi uhlobo lokucindezela enxebeni usebenzisa izicathulo ezikhethekile noma ngokukhipha ngokuhlinzwa
• Ukwenza ngcono ukuhlinzekwa kwegazi nge-Angioplasty noma ukuhlinzwa kwe-bypass uma ukuhlinzekwa kwegazi onyaweni kuncane
• Ukuhlinzwa ukuze kukhishwe izicubu ezinegciwane noma ezifile uma izilonda ziba nzima
• Ukulaliswa esibhedlela ngenxa yezifo ezimbi kakhulu ezidinga ama-antibiotics emithanjeni

Izinhloso eziyinhloko ukuvimbela ukutheleleka kanye nokwandisa isilonda ngenkathi usebenza ukusiza isilonda ukuba siphole. Ukulawula ushukela wegazi okuqinile nokulandela iziqondiso zikadokotela wakho kubalulekile ngesikhathi sokuphulukiswa ukuze ugweme ukuphindeka.

Prevention

Indlela ephumelela kakhulu yokugwema izilonda ezinyaweni zesifo sikashukela iwukunakekela ngenkuthalo ukuvimbela okuhlanganisa:

• Ukulawulwa okuqinile koshukela wegazi ukugcina amazinga eglucose afanele
• Ukuhlolwa kwezinyawo kwansuku zonke nganoma yikuphi ukungahambi kahle noma izinguquko
• Ukugcina izinyawo zihlanzekile futhi zomile, zomile, izinzipho zisikiwe
• Gqoka izicathulo ezifanele futhi amasokisi ahlanzekile kufanele ashintshwe nsuku zonke
• Ukuvakasha kwe-podiatrist okuvamile ukuze kuqashwe i-neuropathy, ukukhubazeka
• Gwema ukubhema

Ukulungiswa kwendlela yokuphila njengokugcina a Ukudla okunempilo, ukuvivinya umzimba njalo, ukugwema ukusebenzisa ugwayi nokufunda izindlela ezifanele zokunakekela unyawo izingozi eziphansi kakhulu. Ukubona nokulungisa izinkinga zezinyawo kusenesikhathi kuyisihluthulelo kulabo abanesifo sikashukela. 

Uyombona Nini Udokotela?

Labo abatholakala benesifo sikashukela kufanele bahlele ukuhlolwa kwe-podiatry kanye ngonyaka ukuze baqaphe impilo yezinyawo, bahlole ukulimala kwemizwa, ukutholakala kwegazi kanye nokuhlola izici eziyingozi zomuntu siqu zezilonda. 

Labo abatholakala benesifo sikashukela nezinkinga zezinyawo njengokuzwa ukuncipha noma ukwehla kokunikezwa kwegazi kufanele bahlele ukuvakasha kwabo kanye ezinyangeni eziyisi-6.

Noma yiziphi izimpawu ze isikhumba izinguquko, ukucasuka noma okungavamile kufanele kulungiswe ngokushesha udokotela wakho ukuze anqume izinyathelo ezilandelayo. Ukulinda noma ukubambezeleka ngokunganaki kuvumela izilonda ezincane ukuba zibe zikhulu futhi zitheleleke kakhulu. Ngakho-ke kubalulekile ukufuna ukunakekelwa ngokushesha lapho uqaphela izinkinga ezingase zibe khona ezinyaweni zesifo sikashukela. Hlala uqaphile - impilo yakho yonyawo incike kukho.

Isiphetho

Izilonda ezinyaweni zesifo sikashukela ziyinkimbinkimbi engaba khona ethinta iziguli eziningi ezinesifo sikashukela kodwa ngokuvamile zingavinjelwa noma zelapheke uma zibhekwa ngendlela efanele. Ukuqonda izici zakho zobungozi, ukuzihlola ngokwakho kanye nokusebenza eduze nethimba lakho lezokwelapha kungasiza ukumisa ukuqhubekela phambili ekubeni kubi kakhulu. ukutheleleka, ukulaliswa esibhedlela, noma kungenzeka ukunqunywa isitho. 

Isifo sikashukela singaba yisifo esilawulekayo uma sihlonyiswe ngolwazi lokuthatha izinyathelo zokuvimbela ukwehlisa ubungozi bezinkinga zesikhathi eside. Yiba matasa futhi ukhulume lapho ubona noma yiziphi izimpawu zokuqala noma izinguquko zonyawo. Ukunakekelwa okungaguquki nokuphatha kusiza ukugwema ukuthuthukela emiphumeleni enzima - lokhu kusebenza ekulinganiseni amazinga kashukela egazini kanye nokuqapha impilo yezinyawo.