Diabetic foot and wound care in non-healing open wounds that are commonly located at the base of the foot are known as diabetic foot ulcers. Individuals with diabetes have a higher risk of having diabetic foot ulcers. Foot ulcers are formed as a result of the breakdown of skin tissue which leads to the exposure of the underneath layers.
Anyone who has diabetes has the tendency to be affected with foot ulcers depending on how well they control diabetes and care for their foot.
Most foot ulcers are found under the big toes or the balls of the feet. Foot ulcers can affect the skin at the bottom of the foot down to the inner bones. If it is not timely treated, the patient could be infected and could lead to lower-extremity amputations.
Causes of diabetic foot ulcers
Every patient with diabetes has a higher risk of developing foot ulcers. There are several factors that could lead to foot ulcers.
- Poor circulation of blood could lead to foot ulcers. It can also make it difficult for the ulcer to heal. Vascular disease can lead to poor circulation of blood to the foot.
- Patients with diabetes can develop neuropathy. Neuropathy is the inability to feel pain in the feet due to nerve damage caused by an increased level of blood sugar. This condition could lead to foot ulcer. High glucose levels can slow down the healing process of the foot ulcers which could lead to infection.
Other causes of foot ulcers include:
- Foot deformities
Risk factors for developing foot ulcers
The most well-known risk factors that cause foot ulcers include diabetic neuropathy, auxiliary foot disfigurement, and peripheral arterial occlusive disease. A cautious physical examination, followed by monofilament testing for neuropathy and non-invasive testing for blood vessel inadequacy, can identify patients susceptible to foot ulcers, and also identify patients who already have ulcers or other diabetic foot diseases.
Proper education regarding foot hygiene, nail care and footwear are significant so as to reduce the risk of sustaining an injury that could lead to the formation of foot ulcers. Diabetic foot complexities are the most widely recognized reason for non-traumatic lower extremity amputations. The risk of lower extremity amputations is 15 to 46 times higher in diabetic patients than in people who don’t have diabetes mellitus.
The risk factors of diabetic foot ulcers include:
- Race – African-Americans, native Americans and Hispanics are at higher risk of developing diabetic foot ulcers.
- Age – Aging adults, especially older men are at higher risk of developing diabetic foot ulcers.
- Obesity – Individuals who are overweight
- Excessive intake of alcohol
- Smokers are at a higher risk of developing foot ulcers.
- People who use insulin frequently are at higher risk.
- Patients with diabetes-related kidney
- Patients with heart disease
- Wearing of poorly fitted shoes
- Improper trimming and care of toenails
- Patients with eye disease from diabetes
Symptoms of diabetic foot ulcers
The ability to recognize diabetic foot ulcer symptoms is very crucial for early treatment and cure. If a diabetic foot ulcer is not timely treated, it can lead to infection, permanent disfigurement or lower extremity amputation.
The signs of diabetic foot ulcers are not always obvious, especially at the early stages. Sometimes, you won’t even see any signs until the ulcer become infected. Due to nerve damage, you may not feel any pain. This will prevent you from knowing that you have foot ulcers.
You need take notice of every little change that takes place on your foot.
Symptoms of Diabetic foot and wound care include:
- Skin discoloration around the affected area
- Loss of sensation or numbness
- Unusual swelling
- Warmth around the affected area
- Dry and thickened skin around the wound
- Black tissue surrounding the ulcer
- Gangrene (tissue death due to infections)
- Drainage coming out from the wound
- Bad odors from the wound
- Skin cracking
- Bleeding from the wound
- Advanced stages lead to fever
Diagnosis of diabetic foot ulcers
When diagnosing for Diabetic foot and wound care, your doctor will most likely conduct a physical examination of your foot.
He or she will inspect your feet, toes and toenails for cuts, scratches, blisters, or ingrown toenails.
Your doctor will review your medical history and ask you some health-related questions. Your doctor may also ask you the type of shoes you normally wear, the ways with which you keep your feet clean and healthy.
You may be asked to stand and walk so that the weight of your body and the pressure on your feet can be assessed. If you limp, this may indicate structural damage.
Your doctor will also examine your blood sugar level and blood circulation.
Your doctor will check the wound to know if there is any infection and how deep the wound is. He/she will check if there are any infections such as cellulitis or osteomyelitis.
Your doctor will also check to know if you have circulatory problems, foot abnormalities or diabetic neuropathy.
Your doctor will most likely check your reflexes, examine the sensation around your feet or examine your feet to know if you feel vibrations.
Your doctor may check blood circulation in your feet and legs by feeling your pulses. He/she will also check if your feet are warm and pinkish in color.
Doppler ultrasound may be used to test blood circulation in cases of weak pulses.
The severity of the ulcer will be observed by using a cotton swab or other instruments to check how deep the ulcer is. Your doctor will also check to know if the ulcer has eaten deep into the bones and tendons.
Your doctor may conduct different kinds of tests to know the extent or severity of the ulcer. Your doctor will also check if the ulcer is infected.
The tests that you may undergo include:
A blood test is done so that your doctor can screen for any form of infection. If the ulcer is reddish in color, swollen or you feel warm around the area, a blood test may also be conducted.
MRI scans are done so that your doctor can know the extent of damage caused by the ulcer. It shows the bones and reveals any inflammations that may have occurred.
You may undergo an X-ray so that your doctor can examine the internal bones and tendons for any infection or damages. Conditions such as loss of bone mass, changes in the alignment of bones, weakened bones and fractures may occur. It is important that any of these conditions are detected early help to prevent a worse case of amputations.
CT scan is needed to check and examine internal organs and bones.
Sample of the ulcer may be collected with a cotton bud or any other thin medical instruments to check for bacteria.
Treatment of diabetic foot ulcer
It is very important to treat diabetic foot ulcers at an early stage to prevent the ulcer from getting infected.
The appropriate treatment methods for Diabetic foot and wound care include:
Managing blood glucose and other related health problems
Keep your blood glucose under control and ensure that you treat every health condition as early as possible.
Preventing the ulcer from getting infected
It is very important that you keep foot ulcers from getting infected. You can keep it from getting infected by having regular foot baths, keeping the ulcer dry with frequent dressing changes, disinfecting the skin around the ulcer, enzyme treatments and dressing the ulcer with calcium alginates to prevent bacterial growth.
Taking pressure off the area (Off-loading)
Take pressure off your feet by sitting or lying down. Taking pressure off your foot helps to lessen the stress exerted on the affected foot. When the pressure is too much on the foot, it can make the ulcer expand and lead to infection. If you are overweight, it is recommended that you take necessary measures to lose excess weight. Also, do not stand on your feet for a long period of time.
Removing dead skin and tissue (Debridement)
Debridement is the removal of dead skin tissue from the surface of the wound. Removing the dead skin and other foreign substances helps to prevent infection and allows for a faster healing process.
Applying medication and dressing the ulcer
After the dead skin tissue is removed, the wound will be cleaned and the necessary medications will be applied before it will be dressed and bandaged.
You may be given antibiotics, anti-platelets, or anti-clotting medications to prevent infection and facilitate the healing process.
You may also need to apply over-the-counter medications and creams such as silver sulphadiazine cream, polyhexamethylene biguanide gel or solutions, iodine, and medical-grade honey in ointment or gel form.
Surgery is the last resort when all other conservative treatment methods have failed. You may undergo surgery to take pressure off the affected area like shaving down the bone or removing foot deformities such as hammertoes, bunions, or bumps.
In extreme cases where the ulcer has gotten infected and refused to heal, your doctor may suggest amputation to prevent the infection from spreading to other parts of the body.
Best place to undergo diabetic foot and wound treatment in Dallas, Plano, & Prosper is Graff Foot, Ankle & Wound Care
Dr. Graff Foot, Ankle, & Wound Care Center is a highly reputable wound care center that performs comprehensive foot, ankle and wound care. We have the best wound treatment facilities and medical professionals to ensure that wounds are thoroughly treated.
All our professionals at Dr. Graff Foot, Ankle and Wound Care are specially trained to ensure that our patients are provided with the best medical services.
All our highly trained staff are prepared and equipped to serve each and every patient. We guarantee the comfort and safety of our patients. No matter the severity of the wound, we are equipped with all medical facilities to treat and heal wounds in a relatively short time.
If you have diabetic foot wounds that don’t heal, we advise you to contact Dr. Graff Foot, Ankle & Wound care clinic. We have the expertise, professional experience, knowledge and facilities to treat non-healing wounds.