There are a number of self-care techniques that can help to lower your risk of developing gangrene. These are explained below.
Foot care
If you have diabetes or another chronic condition that can cause arteriosclerosis (hardening or thickening of the arteries), it is important that you take extra care of your feet.
If you have diabetes, you should have your feet checked at least once a year. However, more frequent check-ups may be required for those who have additional risk factors, such as peripheral neuropathy (lack of feeling, or numbness, in the hands and feet) or a history of previous foot ulcers.
The advice listed below can help you to prevent developing a diabetic foot ulcer.
- Check your feet daily for any problems, such as numbness, discolouration, breaks in the skin, pain or swelling. Report any problems to your GP immediately.
- Avoid walking barefoot outside and wearing shoes without socks.
- Do not use chemical preparations for calluses, corns, or in-growing toenails. Instead, you should contact a podiatrist (a healthcare professional who specialises in foot care).
- Wash your feet daily. Afterwards, make sure that you dry them thoroughly, particularly between the toes. The temperature of the water that you use to wash your feet should be less than 37C (98.6F).
- Avoid using hot water bottles, electric blankets, foot spas and sitting too close to the fire. These may burn your feet, particularly if you have reduced sensation. Burnt tissue is vulnerable to gangrene.
- Have your feet measured properly. If there is a difference between the size of your feet, you should buy shoes to fit the larger foot. Your podiatrist may be able to provide you with specially made-to-measure "diabetic footwear" or they may be able to recommend a stockist.
- Avoid wearing sandals, flip-flops, slip-ons and shoes that have a pointed toe, or heels that are higher than an inch. Shoes that have round or square toes, and laces or fasteners, provide the best support and protection for your feet. Always break new shoes in gradually.
If you have a history of foot ulcers, wearing specially designed therapeutic or orthopaedic shoes can help prevent further ulcers.
Smoking
The damage that is caused by cigarette smoke can cause your arteries to become blocked, resulting in a loss of blood supply to your arms or legs and leading to the development of gangrene.
This is known as peripheral vascular disease (PVD). In the UK, around 2,000 smokers a year have an amputation as a result.
If you decide to stop smoking, your GP will be able to refer you to an NHS Stop Smoking Service, which will provide you with dedicated help and advice about the best ways for you to give up smoking. You can also call the NHS Smoking helpline on 0800 022 4 332. The trained helpline staff will be able to offer you free expert advice and encouragement.
If you are committed to giving up smoking, but do not want to be referred to a stop-smoking service, your GP should be able to prescribe you medical treatment to help with any withdrawal symptoms that you may experience after quitting. See Smoking - treatment for more information as well as the stop-smoking section of Live Well.
Take regular exercise
A healthy, well-balanced diet and regular exercise will help to keep your blood pressure and cholesterol levels at recommended levels, helping to prevent your blood vessels becoming damaged.
A minimum of 30 minutes of vigorous exercise a day, at least five times a week, is recommended. The exercise should be strenuous enough to leave your heart beating faster and you should feel slightly out of breath afterwards. Vigorous exercise includes going for a brisk walk and walking up a hill.
More information about fitness and exercise is also available on the Live Well section of the website.
Diet
For good all-round health, a low-fat, high-fibre diet is recommended that includes wholegrains and plenty of fresh fruit and vegetables (at least five portions a day).
You should limit the amount of salt that you eat to no more than 6g (0.2oz) a day, because too much salt will increase your blood pressure. One teaspoonful of salt is equal to about 6g.
You should avoid eating foods that are high in saturated fat because this will increase your cholesterol level. Foods that are high in saturated fat include:
- meat pies
- sausages and fatty cuts of meat
- butter
- ghee, a type of butter that is often used in Indian cooking
- lard
- cream
- hard cheese
- cakes and biscuits
- foods that contain coconut, or palm oil
Eating some foods that are high in unsaturated fat can help to decrease your cholesterol level. Foods that are high in unsaturated fat include:
- oily fish
- avocados
- nuts and seeds
- sunflower
- rapeseed
- olive oil
See healthy eating (Live Well) for more information and advice about eating healthily.
Alcohol
Drinking too much alcohol will cause your blood pressure to rise, as well as raising the cholesterol levels in your blood.
The recommended daily levels of alcohol consumption are:
- three to four units for men
- two to three units for women
One unit of alcohol is equal to one of the following:
- half a pint of normal-strength lager
- a small glass of wine
- a pub measure (25ml) of spirits.
For more information, see the alcohol section on Live Well.
Lose weight
There are many benefits that are associated with losing weight. If you can reach the ideal weight for your height, it will help lower your cholesterol levels and your blood pressure.
The most successful weight loss programmes include at least 30 minutes of daily exercise, eating smaller portions and only having healthy snacks in between meals. A gradual weight loss of around 0.5kg (1.1lbs) a week is usually recommended.
Also see Obesity - treatment and lose weight (Live Well).
