Diabetic foot ulcer is a sore or open wound that usually occurs on the sole of the foot in approximately 15 percent of patients with diabetes. Six percent of diabetics with a foot ulcer should be hospitalized due to an infection or other complication related to the ulcer.
Womens Diabetic Socks | Seamless Toe + Non-Binding | Crew 3 Pack Size 9-11
Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States, and approximately 14 to 24 percent of patients with diabetes who have a foot ulcer undergo amputation. However, research has shown that it is possible to avoid the appearance of an ulcer on the foot.
Who can have a diabetic foot ulcer?
Anyone who has diabetes can have a foot ulcer. Native Americans, African Americans, Hispanics, and the elderly are more likely to have ulcers. People who use insulin, such as patients who suffer from diabetic nephropathy, diabetic retinopathy or diabetic heart disease, have an increased risk of having an ulcer on the foot. Overweight and the consumption of alcohol and tobacco also affect the appearance of ulcers in the foot.
How are diabetic foot ulcers formed?
Ulcers are formed due to a combination of factors, such as lack of sensation in the foot, poor circulation, deformations in the foot, irritation (due to friction or pressure) and trauma, as well as the time you have been suffering from diabetes . Patients who have diabetes for many years can suffer neuropathy, the decrease or total loss of sensation in the feet as a result of nerve damage caused by hyperglycemia (high blood glucose concentrations) over the years. The nerve damage often occurs without pain and in that way the problem can go unnoticed. The podiatrist can examine your feet for neuropathy with a simple and painless tool known as a monofilament.
A vascular disease can complicate an ulcer in the foot, by decreasing the healing capacity of the organism and increasing the risk of infection. Hyperglycaemia can decrease the body's ability to defend itself from possible infection and even delay healing.
What is the value of treating a diabetic foot ulcer?
As soon as you notice an ulcer, seek podiatric care immediately. Foot ulcers of patients with diabetes should be treated for several reasons such as reducing the risk of infection and amputation, improving functionality and quality of life and reducing the cost of medical care.
How should a diabetic foot ulcer be treated?
The main objective of the treatment of ulcers in the foot is to achieve healing as soon as possible. The faster the healing, the less chance of infection.
There are several key factors in the proper treatment of a diabetic foot ulcer.
- Avoid infection.
- Remove pressure to the area, which is known as "discharge."
- Remove skin and tissue from the fingers, which is known as "debridement".
- Place medications or dressings to the ulcer.
- Control blood glucose (blood glucose concentration) and other health problems.
- Not all ulcers become infected; However, if your podiatrist diagnoses an infection, a program of antibiotic treatment, wound care and probably hospitalization will be necessary.
Several important factors allow you to prevent an ulcer from getting infected:
- Strictly control blood glucose.
- Keep the ulcer clean and bandaged.
- Clean the wound daily and use a dressing or bandage on the wound.
- Do not walk barefoot.
- For optimal healing, ulcers must be "unloaded", particularly those of the soles of the feet. Patients should be asked to wear special footwear, a brace, specialized castings, or a wheelchair or crutches. These devices will reduce pressure and irritation in the area of the ulcer, accelerating the healing process.
The science of wound care has progressed a lot in the last 10 years. Nowadays it is known that the old concept of "let's go in the air" is harmful for healing. We know that wounds and ulcers heal faster and with less risk of infection if they are kept covered and moist. The use of concentrated betadine (antiseptic and odophor), oxygenated water or immersion baths is not recommended since it can cause complications.
Appropriate treatment of wounds includes the use of dressings and the topical application of medications. These medications range from saline solution to cutting-edge products such as growth factors, ulcer dressings and skin substitutes, which have proven to be very effective in healing ulcers.
For a wound to heal there must be adequate blood circulation in the ulcerated area. The podiatrist can determine the level of circulation with non-invasive tests.
Control of blood glucose
The strict control of glycaemia is of utmost importance during the treatment of a diabetic foot ulcer. Working together with a general practitioner or endocrinologist to achieve this will promote healing and reduce the risk of complications.
Surgical alternatives
Most uninfected foot ulcers are not treated surgically; however, when treatments fail, surgery may be appropriate. Examples of surgical care to remove pressure from the affected area include scraping or removal of bone (s) and correction of various deformations, such as hammertoes, bunions, or bony "protuberances."
Healing factors
The healing time depends on a number of factors, such as the size and location of the wound, the pressure exerted on it when walking or standing, inflammation, circulation, blood glucose, wound care and what it is being applied. Scarring can occur in weeks or need several months. Needs, or "protrusions" bony.
How can the onset of an ulcer on the foot be prevented?
First of all, the best way to treat a diabetic foot ulcer is to prevent it from forming. One of the recommendations is to consult a podiatrist periodically. The podiatrist will be able to determine if you have a high risk of developing an ulcer in the foot and propose preventive strategies.
You have a high risk if:
- suffers a neuropathy,
- It has poor circulation,
- has a deformation in the foot (ie a bunion or the hammer toe),
- wear inappropriate shoes,
- it does not have its glycemia controlled.
- Reducing risk factors such as smoking, drinking alcoholic beverages, having hypercholesterolemia (high cholesterol levels) and hyperglycemia are important measures to prevent and treat diabetic foot ulcer. Wearing appropriate socks and shoes will go a long way in reducing risks. Your podiatrist can guide you in choosing the right shoes.
It is essential that you learn to control your feet so that you notice the problem as soon as possible. Examine your feet every day-especially the plant and between your fingers-for cuts, bruises, cracks, blisters, flushing, ulcers, and any out-of-the-ordinary signs. Every time you visit your doctor, take off your shoes and socks so you can examine your feet. You should inform the podiatrist of any problem you discover as soon as possible, no matter how "insignificant" it may seem.
The key to good wound healing is periodic podiatric care to ensure "excellence in quality" of care in:
- reduction of blood glucose
- Adequate debridement of wounds
- treatment of any infection
- reduction of friction and pressure
- restoration of adequate blood flow
- The old adage, "better safe than sorry" is applied more than ever when it comes to preventing a diabetic foot ulcer.
This booklet belongs to a series designed by the APMA that analyzes various conditions and other issues of interest related to foot health, including bunions, arthritis, dermatophytosis of the foot (foot athlete), warts, orthopedic foot, aging, the feet of children, surgery of the anterior or posterior part of the foot, problems of the female foot, walking, pain in the heel, problems of the nails, footwear and others. They are not intended to replace the professional advice of your podiatrist. The brochures can be obtained from those associated with the APMA.