Episode 1 of OFFLOAD: Debridement of an Infected Diabetic Foot Wound

[xpixilovesmakeupx]

Holly Moses, how the hell did that guy just sit there while some gezzer cuts skin off his foot? Sonic debrider - looks like a chuffin chisel, hell, I'd be screaming like a banshee unless ya knocked me out, which to get within 1 millimetre of my feet you would need to.

[MrShsh5]

Nice to chew after

[NcalBoyz]

Yummy

[nigen]

part 2? 0.o

[532131]

Watch this with the snowflakes on. It make things less graphic. Hurry while it lasts!

[JumperSC]

Why am I here again?????? Oh yeah...because I have a problem...

[flappy188]

necrotic tissue doesnt bleed?



[MrBeergoggles1]

hmm.. leme wait til half my foot's fallin off before i decide to get it checked out.. great job einstein

[prestellad]

@MrBeergoggles1 In extreme cases of diabetes you lose feeling in your extremities, so he probably didn't notice it. The smart thing would have been for him to constantly check his feet for signs of injury or infection, but some diabetics just aren't as thorough as they should be. I'm sure he won't let this happen again.

[Wellington5392]

OMG! THere aint no way I would let anyone cut open a wound like that on me, without giving me general anesthetic!

[FUGlitchyLogin]

Where is the rest of it? I'd like to see it, thanks.

[WandaYue]

oh my gosh what @.@

[Commonwealth96]

Oh god, once you got to the ultrasonic remover... bleck

[youneveri]

nightmares

[MissCullenNati2]

GAG!

[crazyfighter89]

OMG O.O

[olga159]

i almost passed out

[RibberDibber11]

I dont know but I JUST FREAKIN LOVE THIS VIDEOS!

[sargennipple]

EEEEWWWW EW EW EW EW EWWWWW!! its like what the f*ck happened to him?

[slipknotmaggotful]

How does this heal?

[JaaaYDesigns]

GROSS

[janeyanna]

Have you ever used maggot therapy for diabetic patients?

[pvmayer]

@janeyanna No we haven't, but only because it is diificult to obtain the maggots from California. We are in ontario. The process is not user friendly as it involves getting health canada approval before starting. It doesn't lend itself to prompt treatment. We are eager to include them into our wound practice!

[MultiDouglas95]

its dripping



[pvmayer]

amazingly, no. These patients all have severe diabetic neuropathy. Their feet are completely numb and therefore they don't feel injury nor any of our work.

[18elana]

Do you numb the area first?

[CrappyJokes]

How the hell did I even stumble upon this video...

[MusicOfAdam]

@CrappyJokes Hearing of my uncle's condition brought me here. Like you, I regret doing so... xO

[youneveri]

freaky

[nigen]

why do I watch this shit...

[Bloodshotbuddah]

@nigen You were called to it like the rest of us lol

[I0wn3ey0u]

Ouch

[aljohn08ferrer]

youre a good doctor!

[demonic41700]

during the end was that tool like hot steam or was it like a hot for a specific type of reason OR was the persons foot just spaying out a liquid?

[pvmayer]

@demonic41700 Neither. The ultrasonic debrider works by vibrating at a very high frequency. In order for the vibration to disrupt devitalized tissue there has to be a liquid interface and that is what you see in the video.

[demonic41700]

@pvmayer oh...thanks

[andorfun]

Can you offer pre-nursing students like me tips on how to desensitize wrt procedures like this?

[pvmayer]

@andorfun Time and experience helps make it easier.

[marcs990]

Agh man it stopped just as it was getting good.

[PowerfulFoe]

@marcs990 Yeah =/ I wanted to see the complete stuff, too.

[Mahomael]

Everytime I see vids like these, I'm reminded again and again, why I should follow my doctor's suggestions to the exact letter. If I did have diabetes, you can be damn sure I'd be doing everything possible to reduce the effect of the disease. And if I'd just had any type of surgery, I sure as hell wouldn't be walking in floodwater of any type.... the millions of bacteria that thrive in there alone would demand I call someone else to do whatever it was that was so urgent it couldn't wait..

[sinaihuerta]

all I saw was stuff spraying out of his foot.....

[NDKfrl]

The strange thing is, people actually don't care about infections like these and only visit a doctor if it starts to look reaal bad. Human stupidity is uncomprehensible to me.

[pvmayer]

@NDKfrl Its not so much that they don't care but more that they don't FEEL. Diabetes is a disease without symptoms until the symptoms appear, and then it is to late. Prevention is the key to successful treatment, but is very difficult to sell to the symptomless patient!

[sarahthediva]

I bet the patient couldn't walk after this procedure

[pvmayer]

@sarahthediva He walked in and he walked out. He has no feeling in his feet as a result of the nerve damage from diabetes.

[KrautGoesWild]

I´m still somewhat at a loss about how just by walking through the water, the patient´s foot became like that.

Did he step on something without noticing it?

And, looking at the debridement, I´m wondering if this person was... what is it called... neuropathic (had no sensation of pain)?

[pvmayer]

@KrautGoesWild He already had an ulcer that we were treating under his 1st MTP joint(under the 1st toe knuckle). He then went walking in the dirty water and the open wound got infected. Yes is completely neuropathic, ie, he has no felling in his feet.

[KrautGoesWild]

@pvmayer Thank you! One more question, if you please: Does neuropathy occur to all patients with diabetis mellitus? My father is D.M., too but since his stroke back in 2002, he is unable to give any clear answer to questions.

I just got positively tested on diabetis, so I´d like not to end up one day pulling my foot out of my boot and see a nail, scissor, pebble, whatever sticking in it and watch that part of my body dropping off just because I didn´t feel stepping on it.

[pvmayer]

@KrautGoesWild The majority of people with diabetes will have some form of neuropathy after 5 years of having diabetes. The worse the blood sugar control the faster it develops. For people who can't verbalize whether they can feel monofilament testing, nerve conduction studies can be done.

[beadyeyeproductions]

This video is extremely graphic but I am glad a video like this is the top video for diabetic foot on youtube. Its one thing to hear someone talking about it but this visual is more eye opening than a million talks. Thanks for the Vid.

[pvmayer]

@beadyeyeproductions Unfortunately, this happens every day. Diabetics need to know about the what the real complications of their disease looks like  and then do something to prevent it from happening. Diabetic management is all about prevention!

[HTK30]

this shouldnt even be happening these damn doctors are all fucking kwack's thats also why the healthcare field is broken!!!!!!!

[vv886]

eeeeeeeeeeeeeeeeeeeeeeeeeeeeee­eeeeeeeeeeeeeeeeeeeeeeeeeeeeee­eeeeeeeeeeeeeeeeeeeeeeeeeeeeee­eeeeeeeeeeeeeeeeeeeeeeeeeeeeee­eeeeeeeeeeeeeeeeeeeeeewwwwwwww­wwwwwwwwwwwwwwwwwwwwwwwwwwwwww­wwwwwwwwwwwwwwwwwwwwwwwwwwwwww­wwwwwwwwwwwwwwwwwwwwwwwwwwwwww­wwwwwwwwwwwwwwwwwwwwwwwwwwwwww­wwwwwwwwwwwwwwwwwwwwwwwwwwwwww­wwwwwwwwwwwwwww omfg

[Frikti0n]

awww I wanted to see the rest!

[PrettyTigerlilly]

Use maggots, they do a lovely job.

[ACMommy28]

oh please please PLEASE tell me this person wasn't feeling any of this!!! Just watching it made my stomach knot up!!

[pvmayer]

@ACMommy28 didn't feel a thing. He is completely neuropathic,ie, he has no feeling in his feet whatsoever. This is the reason he got the diabetic wound in the first place.

[OEKCVB]

@pvmayer Lord Jesus i pray that doctors can keep his feet safe and that he is cured? and he is able to walk well God bless you very much much love of the Lord be with you Amen

[par0l]

i watched this cause im panicing cause i stood on a rusty nail today and this shit kinda makes me feel better

[pvmayer]

@par0l make sure you get a tetanus shot if you haven't got one in the past ten years

[rickybarningham]

in sum sick, twisted, disturbing way, it was very satisfying watching this.......i guess im physcotic

[Aipom777]

kebab!

[DEP717]

My Grandma lost a foot to diabetes. If they can save this guy's foot God bless them.

[niamtxiv]

I'm 21 and I'm diabetic. My left foot has callouses and started turning yellow, but i constantly clean my foot, exercise, eat healthy, cut off soda, red meat, and etc.... i put aloe lotion on my foot and i'm glad my foot is turning healthy again.

[luticia]

@niamtxiv Get well soon,my friend.

[PatriciaNeurocare]

@niamtxiv Hello, my husband suffers from diabetes. He was loosing feeling and his ankles and toes were turning black. We discover this amazing device and obtained a license to manufacture and distribute in the U.K. His feet and have turned pink and his feet feeling has returned to 90%. I dare to think what might have happen wouldnt we have found the device.

[crampoftheballs]

that lads foot is fucked!! truly! 

[chrisapero]

my mom does have diabetes and she has almost no feeling in her feet, but she feels pain anyway.

[QueenAmy]

WOW! The ultrasonic debrider is awesome! It only gets the dead tissue, and not the living... that is really interesting. Brilliant!

[CaribbeanQueen07]

So is being overweight the only way to get diabetes? I have heard you can be thin and get it too. :( how can you prevent getting to this stage?

[pvmayer]

Being overweight is the most common cause of type 2 diabetes. You can, however, become diabetic even if you are thin. Genetics plays a big role in both circumstances. Blame that on your parents. Just try to learn from their life experiences, eat healthy and stay active. PVM

[22Huffman]

@pvmayer It's true that you may be diagnosed with diabetes if it runs in your family, however your body's immune system can accidently turn against itself at ANY POINT in one's life, killing the tissues which secrete insulin, which in turn causes diabetes. I was diagnosed when I was 5, so I've had it for 15 years. Type 1 can't be avoided, however you're right, type 2 can be prevented by eating healthy and getting enough exercise.

[sinaihuerta]

@CaribbeanQueen07 woooooowwww...........super super smart.......hmm.....-_-makes me feel bad

[CaribbeanQueen07]

@sinaihuerta .... do i detect sarcasm lol

[sophiemckellow]

@CaribbeanQueen07

it can run in the family aswell some women even get it during pregnancy...

[wshrews]

Oh... gross. But what is that fancy ultrasonic machine you're using at about 1:36 in? Could you explain a little more in depth how it works?

[blankets3]

i meant how do you actually get diabetes?

[pvmayer]

we can get diabetes by getting fat. the fat damages the pancreas and it also clogs the transport channels that allow the sugar in your blood stream to get into cells. all of this leads to high blood sugar in your blood stream and a multitude of damaging effects throughout the body.

[SkullakaAce]

@blankets3 you sometimes have higher risks of getting diabetes if your heredity, you parents have it or your grandparents, but you can prevent it if eating a healthy diet and excerise.

[blankets3]

This is so nasty!!! Do all diabetics have feet like this? How do I get it?

[pvmayer]

Not all diabetics get wounds like this, but many do. They develop wounds on their feet because they loose feeling in their feet as result of nerve damage from the diabetes. They do not feel pain and therefore continue to walk on open sores or callus without noticing the pain. They will then wear a hole in the sole of their foot just as you or I would wear a hole in the sole of a shoe.

[pvmayer]

no anesthetic. This pt has lost all of his sensation if his feet. That why he got the wounds in the first place and then ewas able to walk around for a week before getting help.

[TheBandita43]

Gah! Was a local anesthetic used, or was the tissue so damaged he couldn't feel anything?

Great vid :)