When it comes to diabetic patients, it’s important they take special precautionary measures so their feet are protected from injury and disease. This is because diabetes increases the risk of developing wounds on the feet.
Failure to treat a foot wound may lead to complications that can significantly impact patients. At best, patients have to take care of their feet while the wound heals, potentially taking away from time spent with loved ones or doing favorite activities. At worst, patients can develop life-threatening conditions.
Fortunately, you can stay healthy and keep the impact on your daily life to a minimum by understanding diabetic foot problems. If you’re interested in prevention, or if you’re already dealing with diabetic foot ulcers, Horizon Foot & Ankle Institute is here to help you. Our experts are dedicated to helping patients reclaim their lives and bodies with treatment, education, and preventative care.
Horizon Foot & Ankle Institute
Because about 15% of diabetic patients will end up with a foot ulcer, it’s important they have access to professionals with the experience to treat the condition. At Horizon Foot & Ankle Institute, we are experts at handling foot ulcers. We’ll help you understand what they are, why they occur, and what your life is going to look like moving forward with treatment.
What Is a Diabetic Foot Ulcer?
Typically located on the bottom of the foot, a diabetic foot ulcer is an open sore that breaks down skin tissues and exposes underneath layers. Most commonly, diabetic patients will find them under the balls of the feet or under the big toes. It’s possible for these sores to get bad enough they’ll affect every layer of tissue down to the bones.
What are Some of the Causes of Foot Ulcers?
In most cases, those who develop foot ulcers will find many causes that are working against them. African Americans, Native Americans, and Hispanics are naturally more at risk. Older men also have a higher risk. Alcohol and tobacco use, as well as being overweight, can play a role as well. Other causes include:
- High Blood Sugar – When a patient has high glucose levels, the healing process of infected ulcers will slow down.
- Irritated Feet – Conditions such as dry skin and other irritations will cause the skin on the feet to crack, develop corns or calluses, or begin to bleed. Ulcers can form from those injuries.
- Nerve Damage – Without the nerves working properly, diabetic patients won’t be able to feel the pain or sensitivity that leads to ulcers.
- Poor Circulation – Without proper circulation, injuries on the feet will have a harder time healing, which can lead to ulcers or exacerbate an existing ulcer.
What Are Some Symptoms of Foot Ulcers?
Diabetic foot ulcers are painful, but because many patients have extreme nerve damage, they may not feel pain as a symptom.
Upon examination, patients might notice drainage on their socks. They may also notice that their feet are red, swollen, and possibly abnormally smelly.
It’s important to check your feet often and be on the lookout for any unusual firmness or numbness. In some cases, patients may not have apparent symptoms, and the ulcer may not be discovered until it’s already become infected. Due to this risk, it’s important to talk to your doctor about any changes to your feet if you’re at risk for diabetic ulcers.
What Are the Diagnosis and Treatment Plans?
Diabetic foot ulcer treatment should be handled promptly so patients have a chance at recovery without infection. As soon as symptoms have been discovered, a patient should contact our office to meet with a podiatrist for an official diagnosis. Under the direction of the team at Horizon Foot & Ankle Institute, we’ll come up with a treatment plan together. This may include:
- Off-loading – or taking pressure off the injured area.
- Debridement – or removing the dead tissues and skin.
- Applying medication to the wound and dressing it.
- Blood glucose – management strategies.
- Using skin substitute grafts – which are made with living cells to heal diabetic wounds faster.
It’s important to remember that every patient’s case is different; what you need is dependent on medical history, current medications, and the status of the ulcer. To ensure we’re creating the most effective treatment plan, we first diagnose the extent of the wound.
As mentioned before, ulcers can affect tissue layers all the way to the bone. However, not all ulcers develop this far. To determine the best path to take, the podiatrist will first determine how much tissue is affected.
For example, an infected ulcer can create abscesses deep in the tissue. On the other end of the spectrum, an ulcer that’s been caught immediately may only affect the skin. Ulcers in between may affect the tendons and joints.
Less-serious ulcers can usually be initially treated at the doctor’s office, followed by care at home. We’ll schedule follow-up appointments to ensure the wound is healing as it should.
More severe ulcers may require multiple visits for treatment. If ulcers pose frequent issues, you may need surgery to alleviate the pressure that’s causing this recurring condition.
What Happens if a Foot Ulcer Becomes Infected?
As with all wounds, there’s a risk of infection if a foot ulcer isn’t treated correctly. If you experience any of the following warning signs, you should see us immediately, as your foot ulcer may be infected:
- Black coloration around the wound
- Unpleasant-smelling discharge from the wound
- Tenderness around the wound
- Chills and fever
If a foot ulcer does become infected, there are additional steps that would probably be taken, depending on the severity and how efficiently it begins to heal. This might include wound care, antibiotics, and a possible stay in the hospital.
An infected wound needs daily care such as cleaning and applying fresh bandages. If there is discharge, the wound may need to be irrigated to allow for effective examination, to encourage proper healing. Topical medications should be applied during bandage changing according to physicians’ instructions.
Your doctor may recommend that you use the following until the wound is healed:
- A wheelchair
- A cast
- A brace
- Specialized footgear
Antibiotics are a standard part of infected diabetic foot ulcer treatment. Typically, these are taken orally, though topical options are also available.
No matter which version you’re prescribed, it’s essential that you finish out the regimen exactly as instructed. As the regimen progresses, you’ll likely see improvement in the wound and even experience lessening symptoms. Sometimes patients take these as signs they can stop their mediation. However, to thoroughly flush the body of infection, you must take the medication as prescribed, even if you don’t feel like you need it. Doing otherwise can result in a relapse, which prolongs recovery time.
If you experience pain with the ulcer, your doctor may recommend over-the-counter painkillers. Certain options, such as ibuprofen, also fight inflammation, which means they’re a good choice if you’re also experiencing a lot of swelling.
In a worst-case scenario, an infected foot ulcer can lead to a hospital stay. If your infected wound is allowed to fester, the infection can spread to other parts of the body. When bacteria enters the bloodstream, it’s called sepsis and is incredibly serious — in fact, untreated sepsis can lead to death.
In response to sepsis, the immune system may cause inflammation in multiple organs, which puts patients at risk of septic shock. This secondary condition affects the circulatory system and puts patients at an even higher risk of death.
Another condition that can send you to the hospital is gangrene. This illness is the result of cell death and is exacerbated by low blood supply, which means diabetic patients are at a higher risk of developing it. It can be, but is not always, caused by bacteria introduction into a cut or sore. The most common symptoms include the following:
- Cold skin
- Fluid-filled blisters
- Skin discoloration
- Clear line between damaged and healthy skin
Gangrene can be treated with antibiotics. However, in the most severe cases, dead tissue may have to be surgically removed. Amputation of the foot or part of the leg may be considered a last resort.
Contact Us Today
At Horizon Foot & Ankle Institute in St. Louis, we are in the business of changing lives. With a quality care plan designed just for you and the issues you’re facing, we are committed to your wellbeing by providing the services you need most to treat diabetic foot ulcers.
Whether you have dealt with diabetes your whole life or are just beginning on this new path, meet our doctors, and let’s come up with a plan to keep your feet as healthy as possible. Our team is dedicated to making you comfortable and ensuring you have all the information you need to make informed decisions about your health.
Are you concerned about your foot health? Are you interested in preventative care? Then it’s time to talk to a podiatrist. Give us a call at (314) 381-1800 to learn more or to schedule your appointment.
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