Who can consult at EDFC?

EDFC provides assessment and treatment for: Diabetic foot ulcers and infections Non-healing wounds Swelling, cellulitis and abscesses Gangrene and limb-threatening conditions Corns, calluses, cracks and recurrent ulcers Neuropathy, burning or numbness Charcot foot and foot deformities Pressure injuries and bedsores Venous, arterial, traumatic and post-surgical wounds Footwear, insole and pressure-related problems Patients without diabetes who have chronic or non-healing wounds may also consult EDFC.

How can I book an appointment?

You can call or WhatsApp EDFC to book an appointment. You may be asked to share: A clear photograph of the wound The duration of the problem Whether you have diabetes Your current city Any fever, swelling, pus, smell or blackening A photograph helps with preliminary guidance but does not replace a physical examination.

What should I bring to the clinic?

Please bring: Recent blood-test reports, especially blood sugar and HbA1c Previous prescriptions A list of current medicines or insulin Wound-culture, X-ray, MRI, Doppler or angiography reports, if available Previous hospital or surgery discharge summaries Photographs showing how the wound has changed The footwear, insole, cast or walking device you currently use Identity proof and insurance documents, if applicable One responsible family member or caregiver, especially if you have difficulty walking or may require a procedure

Should I remove the dressing before coming?

No. Keep the existing dressing in place unless our team instructs you otherwise. Do not apply turmeric, powder, toothpaste, herbal products, strong antiseptics or any new medicine over the wound before your visit.

Should I come fasting?

Fasting is usually not required. Take your regular meals and medicines unless the clinic has specifically advised fasting. Patients taking insulin should carry a light snack or glucose source. Do not stop insulin, blood thinners or any prescribed medicine without medical advice.

How much time should I keep for my first visit?

Please keep approximately 60 to 120 minutes for your first visit. Simple consultation: approximately 30 to 45 minutes Consultation with foot screening or investigations: approximately 60 to 120 minutes Consultation with wound assessment, debridement and dressing: approximately 90 to 150 minutes Emergency or complex wounds may require additional time Waiting and treatment time can vary depending on the patient's condition and emergency cases.

What happens after I reach the clinic?

Your visit generally follows this process: Registration Detailed medical and wound history Blood pressure and blood-sugar check, when required Foot and wound examination by the clinical team Nerve, circulation and pressure assessment Consultation with the doctor Necessary investigations Diagnosis and risk classification Dressing, debridement or immediate treatment, if required Treatment counselling and cost estimate Follow-up or procedure appointment

What information will be recorded during my medical history?

The team may ask about: Duration and control of diabetes How and when the wound started Previous ulcers or amputations Previous dressings, antibiotics, surgeries or hospital admissions Fever, swelling, pain, discharge or foul smell Heart, kidney, nerve or blood-circulation problems Smoking or tobacco use Current medicines and allergies Your daily activity, occupation and footwear Please provide complete information, as these factors can influence wound healing.

What will be checked during the wound examination?

The team may assess: Wound site, size and depth Type and amount of discharge Smell and condition of the surrounding skin Redness, swelling, pus or other signs of infection Dead tissue, slough or excessive callus Exposed tendon, joint or bone Sinus formation or undermining Foot deformity and abnormal pressure points Possibility of deeper infection or bone involvement The wound may be measured and photographed with consent so that progress can be compared during future visits.

Why are both feet examined?

Diabetes and circulation problems can affect both feet even when the wound is present on only one side. Examining both feet helps identify: Loss of sensation Reduced circulation Corns and calluses Cracks or fungal infection Foot deformity Areas at risk of developing another ulcer

What nerve, circulation and pressure tests may be performed?

Depending on your condition, the assessment may include: Monofilament testing Vibration-perception or biothesiometer testing Foot-pulse examination Handheld Doppler examination ABI or TBI TcPO2, when indicated Foot-pressure assessment or podoscan Walking-pattern and footwear assessment Evaluation for Charcot foot or deformity Not every patient requires every test.

What other investigations may be advised?

The doctor may advise: Blood glucose and HbA1c Complete blood count Kidney and liver function tests ESR, CRP or other infection markers Deep tissue, pus or wound culture when clinically indicated Foot X-ray Arterial or venous Doppler MRI for suspected deep infection or bone involvement CT angiography or other vascular imaging Additional tests based on your general health The reason and expected cost of the investigation will be explained before proceeding.

Will I receive a treatment plan during the first visit?

In most cases, an initial diagnosis and provisional treatment plan can be provided during the first visit. The plan may include: Infection control Wound cleaning and debridement Appropriate dressing Pressure relief or offloading Circulation assessment or vascular referral Blood-sugar and medical optimisation Nutrition advice Footwear or customised insole Surgery or reconstruction, when required Follow-up and dressing schedule Some final decisions may require blood tests, imaging, culture reports or consultation with another specialist.

What happens during wound dressing?

During dressing: The old dressing is removed carefully. The wound is examined, measured and photographed with consent. The wound is cleaned. Dead tissue or excessive callus may be removed when necessary. An appropriate dressing is selected according to the wound's depth, discharge, infection and surrounding skin. Pressure relief and walking instructions are provided. The next dressing or follow-up date is scheduled. Different wounds require different dressings; one type of dressing is not suitable for every wound.

Will dressing or debridement be painful?

Routine wound cleaning and dressing usually cause mild or no discomfort, especially when sensation is reduced due to neuropathy . Deep wounds, infected wounds or debridement may cause discomfort. Local anaesthesia, pain-relief medicine or other measures may be used when required.

Will treatment start during the first visit?

When medically appropriate, treatment may begin during the first visit and can include: Wound cleaning Basic or advanced dressing Callus removal Debridement Pressure-relief advice Offloading Blood tests Antibiotic prescription for clinical infection Urgent drainage or admission when necessary Advanced procedures, specialised investigations or surgery may need to be scheduled separately.

Will I need admission or surgery?

Most stable wounds can be treated on an outpatient basis. Admission or urgent surgery may be advised when there is: Rapidly spreading redness or swelling Abscess or severe infection Fever, weakness or systemic illness Blackening or gangrene Deep tissue, tendon, joint or bone involvement Poor circulation threatening the foot Uncontrolled diabetes or another serious medical condition Need for urgent drainage or extensive debridement Being advised surgery does not automatically mean amputation. Surgery may involve drainage, debridement, removal of infected bone, skin grafting, flap coverage, pressure-correction surgery or reconstruction.

What is the expected expense for the first visit?

The cost depends on what your foot actually needs on the day. As an approximate guide: Consultation only: approximately Rs. 1,200 Consultation with a basic foot assessment: approximately Rs. 1,700 to Rs. 3,200 Consultation, assessment and wound dressing: usually approximately Rs. 2,200 to Rs. 6,200 These are indicative ranges, not fixed charges. The final expense depends on the wound's size, depth, infection, dressing material, investigations and any procedure required. The expected cost is explained to you before treatment begins.

Are debridement and advanced treatments included in the dressing charge?

Not always. The following may have separate charges: Removal of dead tissue or extensive debridement Drainage of pus or abscess Advanced wound-care materials Negative-pressure wound therapy Total-contact cast or other offloading devices Customised insoles or diabetic footwear Laboratory tests and imaging Medicines and injections Daycare procedures, anaesthesia or surgery The need, available options and estimated expense will be explained before treatment.

How frequently will I need dressing and follow-up?

The schedule depends on the wound and dressing material used. Some wounds may need daily dressing. Some advanced dressings may be changed every two to seven days. High-risk infections may require review within 24 to 72 hours. Stable, improving wounds may be reviewed weekly or as advised. The team will provide a written or clearly explained dressing and follow-up schedule.

Can my wound heal with dressing alone?

Dressing is only one part of wound treatment. Successful healing may also require: Infection control Adequate blood circulation Blood-sugar management Removal of dead tissue Pressure relief or offloading Appropriate footwear Good nutrition Treatment of swelling Correction of deformity or abnormal biomechanics Vascular or reconstructive surgery when required Treating the cause of the wound is as important as covering the wound.

Can I walk with a foot ulcer?

This depends on the ulcer's location, depth and severity. Some patients may walk only with a prescribed offloading device, while others may need restricted or non-weight-bearing activity. Do not walk barefoot or continue using unsuitable footwear. Follow the walking instructions given by the doctor.

Will I receive antibiotics?

Antibiotics are prescribed when there is clinical evidence of infection. They are not automatically required for every ulcer. When appropriate, a deep tissue, pus or bone sample may be collected to help select the correct antibiotic. Do not start, stop or change antibiotics without medical advice.

How long will my wound take to heal?

Healing time varies between patients and depends on: Wound size and depth Duration of the wound Infection or bone involvement Blood circulation Pressure on the wound Blood-sugar control Kidney and heart health Nutrition Smoking or tobacco use Treatment and offloading compliance After assessment, the doctor will provide a realistic estimate and monitor the wound's progress. No ethical clinic can guarantee a fixed healing time.

Can EDFC guarantee that my leg will be saved?

No clinic can guarantee limb salvage in every case. EDFC makes every medically appropriate effort to control infection, preserve healthy tissue and prevent avoidable amputation. In advanced infection, irreversible gangrene or life-threatening illness, removal of a toe or part of the limb may sometimes be necessary to protect the patient's life.

Can dressing be performed at home?

Home dressing may be allowed after the wound has been assessed and a clear plan has been provided. The patient or caregiver should understand: How to clean the wound Which dressing material to use How frequently to change it How to protect the dressing from water and contamination Which warning signs require urgent review Regular clinical review remains important even when dressing is performed at home.

What if the wound looks small and does not hurt?

Diabetic neuropathy can reduce pain sensation. Therefore, a deep or infected wound may cause little or no pain. Even a small wound, blister , crack or black spot should be evaluated early.

What happens after the wound heals?

Wound closure is not the end of treatment. The foot remains at risk of recurrence. Your prevention plan may include: Daily examination of both feet Regular diabetic-foot screening Safe nail and skin care Medical pedicure Callus management Customised insoles or diabetic footwear Foot-pressure reassessment Blood-sugar management Walking and activity instructions Scheduled follow-up examinations Our goal is to heal the present wound and reduce the chance of another ulcer.

When should I contact EDFC urgently?

Seek urgent medical help if you notice: Fever, chills, weakness or confusion Rapidly increasing redness or swelling Pus, foul smell or increasing discharge New black, blue, pale or cold areas Severe or suddenly increasing pain Rapid increase in wound size or depth Uncontrolled bleeding Very high or very low blood sugar Inability to walk or sudden foot deformity Early assessment provides the best opportunity to control infection and protect the foot.

Consultation Process

What to expect at EDFC, from your first call through assessment, diagnosis, treatment and preventing the next ulcer.

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At EDFC, every patient receives a structured assessment to identify why the wound developed, why it is not healing and what can be done to protect the foot. Our aim is not simply to dress the wound, but to control infection, improve circulation, reduce pressure, correct underlying foot problems and prevent recurrence.

The Process at a Glance

Step 1

Connect With EDFC

Call, WhatsApp or book an appointment. Share a wound photograph when requested.

Step 2

Complete Foot Assessment

We assess the wound, infection, nerves, circulation, foot pressure, deformity and footwear.

Step 3

Diagnosis and Risk Plan

You receive a clear risk assessment and personalised limb preservation plan. Additional tests may be advised.

Step 4

Treatment

Treatment may include wound care, debridement, infection control, offloading, vascular care or reconstructive surgery.

Step 5

Healing Monitoring

Regular measurements, photographs, dressings and treatment adjustments help us monitor progress.

Step 6

Recurrence Prevention

Foot screening, safe foot care, customised footwear, pressure correction and scheduled follow up help protect the foot.

Seek urgent care first if there is fever, rapidly increasing swelling or redness, pus, foul smell, blackening of the toe or foot, severe pain, confusion or sudden weakness. These need attention the same day.

The EDFC Consultation and Treatment Process

Appointment and Initial Guidance

Call or WhatsApp EDFC to book an appointment. You may be asked to share a clear photograph of the wound and briefly describe your symptoms.

Patients with fever, rapidly increasing swelling or redness, pus, foul smell, blackening of the toe or foot, severe pain, confusion or sudden weakness should seek urgent medical attention.

Registration and Medical History

Our team records:

Patient's name, age and contact details
Duration and control of diabetes
Duration and possible cause of the wound
Previous dressings, antibiotics, operations or hospital admissions
Existing heart, kidney, vascular or neurological problems
Current medicines, allergies and previous reports
History of smoking, previous ulcer or amputation

Complete Foot and Wound Assessment

The wound is examined for:

Site, size, depth and tissue condition
Pus, discharge, smell and signs of infection
Dead tissue, callus or exposed tendon, joint or bone
Undermining, sinus formation and surrounding swelling
Foot deformity and abnormal pressure points
Possible bone infection
Photographic documentation for future comparison

Both feet may be examined even when the wound is present on only one foot.

Nerve, Circulation and Biomechanical Assessment

Depending on the condition, the assessment may include:

Monofilament or biothesiometer testing for neuropathy
Foot pulses and handheld Doppler examination
ABI, TBI or other circulation tests
Foot pressure analysis or podoscan
Footwear and walking pattern assessment
Evaluation for Charcot foot, deformity and pressure imbalance

Necessary Investigations

Not every patient requires every investigation. The doctor may advise:

Blood glucose and HbA1c
Complete blood count, kidney function and infection markers
Wound tissue or pus culture when clinically indicated
Foot X ray
Arterial or venous Doppler
ABI, TBI or TcPO2
MRI, CT angiography or other advanced investigations when required

Diagnosis and Risk Classification

The doctor explains:

The likely cause of the wound
Whether neuropathy, poor circulation, infection or pressure is involved
Whether bone or deeper structures may be affected
The possibility of healing and recurrence
The risk to the toe, foot or limb
Whether treatment can be managed through OPD, daycare admission, hospital admission or urgent referral

EDFC may use a colour coded risk system to make the urgency understandable:

Green Foot at risk but no active ulcer or major infection

Yellow Stable ulcer requiring structured treatment and regular follow up

Red Infection, deep wound, poor circulation or rapidly worsening condition requiring urgent intervention

Black Gangrene, severe infection or critical limb threat requiring emergency limb saving treatment

Personalised Treatment Plan

The patient and family receive a written or clearly explained plan covering:

Infection control
Circulation and vascular management
Removal of pressure from the wound
Debridement and wound bed preparation
Appropriate dressing or negative pressure wound therapy
Diabetes and general medical optimisation
Nutrition and lifestyle support
Surgical treatment, if required
Expected follow up schedule
Approximate treatment stages and financial estimate

The initial assessment and provisional plan can often be completed during the first visit. Some decisions may require investigation reports or consultation with other specialists.

Starting Treatment

Depending on the diagnosis, treatment may include:

Wound cleaning and debridement
Drainage of pus or abscess
Appropriate dressings
Antibiotics for clinically infected wounds
Offloading using felt, footwear, walker, cast or customised devices
Callus and pressure point management
Negative pressure wound therapy
Vascular consultation or revascularisation
Skin grafting, flap coverage or reconstructive surgery
Tendon balancing, bone correction or internal offloading surgery
Minor or major amputation only when tissue cannot be safely preserved

Whenever medically possible, the EDFC team follows a limb preservation approach.

Counselling, Consent and Cost Discussion

Before a procedure or surgery, the doctor explains:

The purpose of the proposed treatment
Available alternatives
Possible benefits and limitations
Risks and possible complications
Expected treatment duration
Need for admission or anaesthesia
Estimated cost and follow up requirements

Treatment is started after the patient or authorised family member understands the plan and provides consent.

Follow Up and Healing Monitoring

At follow up visits, the team may:

Measure and photograph the wound
Check for infection or deterioration
Perform debridement
Change the dressing plan
Review culture and investigation reports
Modify antibiotics when necessary
Check circulation and pressure relief
Review offloading compliance
Adjust the treatment plan according to progress

The frequency of visits depends on wound severity. A patient may need review within 24 to 72 hours, weekly, or at another interval decided by the doctor.

Wound Closure and Rehabilitation

After infection control and wound preparation, closure may occur through:

Natural healing
Delayed wound closure
Skin grafting
Local or free flap reconstruction
Corrective foot surgery
Appropriate amputation and rehabilitation when unavoidable

Healing time varies with wound depth, infection, circulation, blood sugar control, kidney function, nutrition, pressure relief and treatment compliance. No ethical clinic can guarantee a particular healing time or complete limb salvage in every case.

Prevention of Recurrence

After healing, the patient receives a prevention plan that may include:

Daily self examination of both feet
Regular diabetic foot screening
Medical pedicure and safe nail care
Callus management
Customised insoles or diabetic footwear
Foot pressure reassessment
Sugar control guidance
Walking and activity instructions
Scheduled follow up examinations

Our goal is not only to heal the present wound, but also to reduce the chance of another ulcer.

Where This Approach Comes From

This process follows current principles that diabetic foot care should assess neuropathy, infection, circulation and mechanical pressure rather than the wound alone, and should use multidisciplinary care when needed, in line with the IWGDF 2023 guidelines and the ADA Standards of Care in Diabetes.

Frequently Asked Questions

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