A diabetic foot ulcer is an open sore on the bottom of the foot that occurs in about 15% of people who have diabetes. Treatment for 6 percent of people with leg ulcers will be related to an infection or an ulcer-related condition.
Foot ulcers are a common condition of diabetes that cannot be treated with diet, exercise, or insulin administration. Ulcers are caused by the breakdown of skin tissue and exposing the underlying layers.
Diabetes is the leading cause of non-painful lower extremity amputations in the United States, and 14 to 24 percent of diabetic individuals with foot ulcers suffer amputations. However, research has shown that foot ulcers are preventable.
They are most common under your big toes and on the balls of your feet, and they can damage your feet from the bones down.
Diabetes can cause ulcers in anyone’s foot, but proper foot care can help prevent them. Treatment of diabetic foot ulcers varies depending on the etiology.
Discuss any foot concerns with your doctor to make sure they are not serious, as infected ulcers can lead to amputation if left untreated.
Who is at risk of developing a diabetic foot ulcer?
Diabetes can cause a foot ulcer in anyone. Ulcers are more common in Native Americans, African Americans, Hispanics, and older men. Insulin users, as well as those with diabetes-related kidney, eye, and heart issues, are at an increased risk of developing a foot ulcer. Being overweight, as well as using alcohol and smoking, all lead to the formation of foot ulcers.
Symptoms of diabetic foot ulcer
Drainage from your foot, which could stain your socks or spill out in your shoe, is one of the predictive factors of a foot ulcer. Signs include unusual swelling, irritation, redness, and smells from one or both feet.
A diabetic foot ulcer is identified by the presence of black tissue (called eschar) surrounding the infection. This occurs due to a lack of normal blood flow to the area around the ulcer.
Around the ulcer, partial or entire gangrene, which refers to tissue death caused by infections, might develop. Odorous discharge, discomfort, and numbness can occur in this condition.
Diabetic Foot ulcers might not always show visible symptoms. Sometimes you may not see signs of an ulcer until it becomes infected.
Consult your doctor if you notice any skin discoloration, particularly black tissue, or if you suffer pain around an area that appears calloused or scraped.
Using the Wagner Ulcer Classification System, your doctor will most likely rate the condition of your ulcer on a scale from 0 to 5:
- No open lesions; potentially a healed lesion
- A shallow ulcer that does not spread deeper layers
- A deeper ulcer that has reached a tendon, bone, or joint capsule
- Presence of deeper tissues, such as abscesses, osteomyelitis, or pain
- Gangrene infecting a part of the forefoot or heel
- Acute infection involvement of the entire foot
Causes of diabetic foot ulcers
Diabetes-related ulcers are most usually caused by:
- Low circulation
- High blood sugar levels (hyperglycemia)
- Nerve Injury
- Feet that are hurt or injured
Low blood flow is a type of vascular disorder in which blood does not flow properly to the feet. Low blood circulation can also make ulcer curing more difficult.
High glucose levels can slow the recovery of an infected foot ulcer, thus blood sugar control is important. People with type 2 diabetes and other diseases often have a more difficult time combating ulcer infections.
Nerve injury is a long-term impact that might cause pain in your feet. Nerve damage can cause trembling and pain. Damage to the nerves affects sensitivity to foot pain and causes painless sores that can develop into ulcers.
Ulcers are identified by bleeding from the affected area and, rarely, a visible swelling that is not usually painful.
What Is the Procedure for Treating a Diabetic Foot Ulcer?
If an ulcer is identified, seek podiatric medical treatment right once. Diabetes patients’ foot ulcers can be treated for several reasons:
- To prevent the possibility of infection and amputation
- To increase performance and quality of life
- To reduce healthcare expenses
Diabetic Foot Ulcers Treatment
The core objective of foot ulcer treatment is to ensure healing as quickly as possible. The faster the wound is treated, the less probable an infection will occur.
Important factors to think about when treating a diabetic foot ulcer:
Infection Prevention
- Taking the stress off the area is known as “off-loading.”
- Debridement is the removal of dead skin and tissue.
- Using medicine or dressings to treat the ulcer
- Managing blood sugar levels and other health issues
Not all ulcers are infectious; however, if your podiatric physician discovers an infection, you will need antibiotics, wound care, and even medical treatment.
Things to consider when preventing an ulcer from becoming infected:
- Maintain effective control over blood glucose levels.
- Maintain a clean and bandaged ulcer.
- Use dressings or bandages to clean the area on a daily basis.
Off Loaded
Ulcers, particularly those on the bottom of the foot, must be “off-loaded” for optimal healing. Patients may be required to wear special footgear, a brace, or customized castings, as well as use a wheelchair or crutches. These devices will relieve pressure and irritation in the ulcer area, helping in the healing process.
Over the last ten years, the science of wound care has changed significantly. The oldest advice “let the air get at it” is now proven to be adverse to recovery. We know that keeping wounds and ulcers covered and moist helps them heal faster and with less risk of infection. Full-strength betadine, peroxide, whirlpools, and soaking are not suggested because they can cause additional difficulties.
Medication and Dressing Treatment
Dressings and topical therapy medicines are instances of appropriate treatment methods. These range from simple saline to advanced products such as growth factors, ulcer dressings, and skin substitutes, all of which have been shown to be highly effective in the healing of foot ulcers.
There must be sufficient flow to the ulcerated area for a wound to heal. Your podiatrist may relate you to a vascular surgeon or order evaluation tests such as noninvasive studies.
Maintaining Blood Glucose Under Control
Controlling blood glucose levels is crucial during the treatment of a diabetic foot ulcer. Working with a medical doctor or endocrinologist to obtain this will help boost healing and reduce the risk of complications.
Surgical Procedures
The majority of noninfected foot ulcers are treated without surgery; but, if this does not work, surgical care may be essential. Lotion or excision of bone(s) and correction of various defects, such as nerve entrapment, bunions, or bony “bumps,” are examples of surgical care to reduce the pressure on the affected area.
Aspects of Healing
Wound size and place, pressure on the injured area from walking or standing, swelling, flow, blood glucose levels, wound care, and what is applied to the wound all impact healing time. Healing can take several months or several weeks.
How Can You Prevent Having a Foot Ulcer?
The best method to cure a diabetic foot ulcer is to avoid it in the first place. Seeing a foot on a regular basis is one of the following guidelines. Determine your chances of getting a foot ulcer and execute prevention techniques.
You are in deep trouble if you:
- Suffer from neuropathy.
- Have poor blood circulation
- Have a broken foot (i.e. bunion, hammer toe)
- Wear incorrect footwear
- Have high blood sugar levels
Smoking, consuming alcohol, having high cholesterol, and experiencing high blood glucose levels are all risk factors that must be avoided in the prevention and treatment of a diabetic foot ulcer. Wearing suitable shoes and socks will help to reduce concerns. Your services efficiently physician can advise you on the best shoes to wear.
Learning how to maintain your feet is important for identifying possible problems as soon as possible. Check your feet every day for cuts, bruises, cracks, blisters, redness, ulcers, and any other problems, especially between the toes and the sole. Remove your shoes and socks whenever you visit a healthcare doctor so that your feet can be checked. Any issues found should be reported to your podiatrist or a medical professional as soon as possible, regardless of how “simple” they look to you.
Regular podiatric medical care is crucial for successful wound healing because it provides the right instruction and care:
- Reducing blood sugar levels
- Wound treatment that is required
- Infection treatment
- Friction and pressure reduction
- Maintaining normal blood flow
How long does it take to heal a foot ulcer?
An ulcer might take weeks or months to heal (with treatment).
Is it possible to spread foot and toe ulcers?
Foot ulcers are not the same as other foot diseases that might be spread from person to person (contagious). You may spread or get a foot or toe ulcer from another person.
Conclusion
Foot ulcers are cured if discovered early. If you get a sore on your foot, see a doctor straight away because the probability of infection improves the longer you wait. Surgical procedures may be needed if infections are not managed.
Stay off your feet and stick to your treatment plan while your ulcers heal. It can take many weeks for diabetic foot sores to heal. If your blood sugar is high and continual pressure is applied to the ulcer, it may take longer to heal.
The most effective method to repair foot ulcers is to keep a diet that helps you maintain your glycemic targets and off-load pressure from your feet. Once an ulcer has healed, regular preventive care will help you avoid a repeat.
