What Is Linked to 11 Million Deaths a Year? Sepsis, Foot Wounds and Poor Circulation
Sepsis happens when the body's response to an infection begins to damage its own tissues and organs. It can become life-threatening quickly. In this World Sepsis Day video, I explain why a worsening foot wound deserves particular attention when someone has diabetes or poor circulation.
As a vascular surgeon in Singapore, I look at two linked questions: is the wound infected, and is enough blood reaching the foot for it to heal? Both matter when deciding how urgently someone needs care.
What does the figure of 11 million deaths mean?
The figure in my video reflects a major global estimate: approximately 48.9 million sepsis cases and 11 million sepsis-related deaths worldwide in 2017, reported in research published in 2020. These figures describe the scale of the problem; they are not a new count for 2026 or a prediction of what will happen to an individual patient.
Sepsis can arise from many infections. A foot wound is one possible source, particularly when infection spreads or a person's ability to fight infection and heal is impaired.
Why can a small foot wound become serious?
A small break in the skin can allow infection to develop. Diabetes, kidney disease and poor arterial circulation can complicate the situation. A history of smoking also matters because it increases the risk of vascular disease. The appearance of the wound alone does not tell the whole story.
When peripheral arterial disease reduces blood flow, the tissues may not receive enough oxygen and nutrients to support healing. Antibiotics and appropriate dressings may be necessary, but they do not automatically correct a circulation problem. Infection control and assessment of blood supply need to be considered together.
Can a diabetic foot infection be serious without much pain?
Yes. Diabetes can damage the nerves that normally warn us about an injury. A wound or infection may therefore hurt less than expected. Little pain is not reliable reassurance, especially if the foot looks different, the wound is worsening or the person feels unwell.
This is why I encourage patients and families to notice changes rather than wait for severe pain. A new wound, spreading redness, increasing swelling, discharge or a change in skin colour needs attention, even when walking remains possible.
Which warning signs need urgent help?
A foot wound needs prompt medical assessment if it develops pus, worsening redness or swelling, severe pain, black tissue or a rapid change in appearance. In someone with diabetes or known poor circulation, do not wait for a wound to become large before seeking help.
Possible sepsis is an emergency. Warning signs may include:
New confusion, unusual drowsiness or sudden deterioration.
Severe shivering, fever, or feeling markedly unwell.
Breathlessness or unusually rapid breathing.
Passing very little urine.
Mottled, pale, blue or otherwise discoloured skin.
Not everyone has every sign. If someone with an infection becomes seriously unwell, seek emergency care immediately; in Singapore, call 995 when emergency ambulance help is needed. Do not wait for a routine clinic appointment.
How does a vascular assessment help?
I assess the wound alongside the person's symptoms, medical history, foot temperature, skin changes and pulses. When indicated, blood-flow tests or vascular ultrasound help establish whether narrowed or blocked arteries are contributing to poor healing. Further imaging depends on the findings and the treatment being considered.
The plan may involve infection treatment, wound care, pressure relief and management of diabetes and other risk factors. Some patients also need a procedure to improve circulation. The right sequence depends on the severity of infection, the blood supply and the person's overall health.
Where can I discuss a foot wound or circulation concern in Singapore?
For a non-emergency vascular assessment, contact Andrew Choong Vascular Surgery at Mount Elizabeth Novena Specialist Centre, #09-22, 38 Irrawaddy Road, Singapore 329563. I can assess whether poor circulation is affecting healing and discuss an appropriate treatment plan.
This article accompanies my video for general patient education. A worsening wound needs an individual assessment, and suspected sepsis requires immediate emergency care.