What is a Diabetic Foot Ulcer?
A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.
Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable.
Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.
Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain, and one may not even be aware of the problem. Your podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament.
Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection. Elevations in blood glucose can reduce the body’s ability to fight off a potential infection and also slow healing.
Diabetic Foot Ulcers: Expert Care Strategies
You are at high risk if you have or do the following
- Neuropathy
- Poor circulation
- A foot deformity (e.g., bunion, hammer toe)
- Wear inappropriate shoes
- Uncontrolled blood sugar
- History of a previous foot ulceration
Symptoms
Because many people who develop foot ulcers have lost the ability to feel pain, pain is not a common symptom. Many times, the first thing you may notice is some drainage on your socks. Redness and swelling may also be associated with the ulceration and, if it has progressed significantly, odor may be present.
Treatment Options - Katy, TX
Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers in patients with diabetes should be treated to reduce the risk of infection and amputation, improve function and quality of life, and reduce health-care costs.
1. At Home Care
- The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis. Your podiatrist can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.
- Learning how to check your feet is crucial so that you can find a potential problem as early as possible. Inspect your feet every day—especially the sole and between the toes—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health-care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your podiatrist as soon as possible; no matter how simple they may seem to you.
- The key to successful wound healing is regular podiatric medical care to ensure the following “gold standard” of care:
- Lowering blood sugar
- Appropriate debridement of wounds
- Treating any infection
- Reducing friction and pressure
- Restoring adequate blood flow
2. Office treatment – conservative:
- Prevention of infection
- Taking the pressure off the area, called “off-loading”
- Removing dead skin and tissue, called “debridement”
- Applying medication or dressings to the ulcer
- Managing blood glucose and other health problems
- keep blood glucose levels under tight control;
- keep the ulcer clean and bandaged;
- cleanse the wound daily, using a wound dressing or bandage; and
- avoid walking barefoot.
For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” You may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches.
These devices will reduce the pressure and irritation to the area with the ulcer and help to speed the healing process.
The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection,
if they are kept covered and moist. The use of full-strength betadine, hydrogen peroxide, whirlpools, and soaking are not recommended, as these practices could lead to further complications.
3. Permanent:
Common Questions on Foot Ulcer Treatment and Care
What is a foot ulcer?
A foot ulcer is an open sore that commonly develops on the bottom of the foot.
Who is at risk for foot ulcers?
Patients with Diabetes and poor circulation are at higher risk.
How are foot ulcers treated?
Why is early treatment important?
Early care helps prevent infection and serious complications.
Advanced Wound Care for Foot Ulcers
If you notice an open sore on your foot that is slow to heal, seek care immediately. Early treatment is critical to prevent infection and serious complications.
Our board-certified podiatrists specialize in diabetic wound care for patients throughout Katy, Cypress, Cinco Ranch, Richmond, and Fort Bend County.
Call us at (281) 395-3338 or request an appointment online.
