Diabetic Foot Ulcers occur in 15% of patients with diabetes, and when left untreated can lead to hospitalization, surgery and even amputation.
Scheduling an appointment with the podiatrists and surgeons of AFACC early can help you detect foot ulcers early, and develop a recovery plan before infection strikes.
Fill out the form to the left to schedule an appointment with an AFACC podiatrist for a foot assessment and treatment options, or read more about causes & symptoms of diabetic foot ulcers below.
What is a Diabetic Foot Ulcer?
A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 15 percent of patients with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.
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 develop a foot ulcer have an amputation. Research, however, has shown that the development of a foot ulcer is preventable.
What Causes Diabetic 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) trauma
Duration of diabetes
Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling 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.
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 retard healing.
How Should a Diabetic Foot Ulcer be Treated?
There are several key factors in the appropriate treatment of a diabetic foot ulcer:
- 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.
The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible – the faster the healing, the less chance for an infection. If your podiatric physician does diagnose an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
There are several important factors to keep an ulcer from becoming infected:
- Keep blood glucose levels under tight control
- Keep the ulcer clean and bandaged
- Cleanse the wound daily, using a wound dressing or bandage
- Do not walk barefoot
For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Patients 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 ulcer area and help to speed the healing process.
Ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.
The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.
For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.
A majority of noninfected foot ulcers are treated without surgery; however, when this fails, surgical management may be appropriate. Examples of surgical care to remove pressure on the affected area include shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony “bumps.”
For more information on Diabetic Foot Ulcers, or to have your feet assessed and treated, contact us today to schedule an appointment at the AFACC clinic nearest you.