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.
Approximately 14-24 percent of patients with diabetes who develop a foot ulcer may require an amputation.
Research has shown, however, that development of a foot ulcer is preventable.
CAUSES: Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers.
- 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.
- 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.
- Many times, the first thing a person may notice is some drainage on their socks.
- Redness and swelling may also be associated with the ulceration and, if it has progressed significantly, odor may be present.
- 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.
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
If the podiatrist diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
- To keep an ulcer from becoming infected, it is important to:
- Keep blood glucose levels under tight control;
- Keep the ulcer clean and bandaged;
- Cleanse the wound daily, using a wound dressing or bandage;
- Avoid walking barefoot.
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