Diabetic Foot Ulcers
Diabetes can often lead to numbness and loss of sensation in the extremities (diabetic peripheral neuropathy), which can cause injuries and other health complications that affect the feet to go unnoticed. When an unnoticed affliction is combined with poor blood circulation and possible infection, it can lead to diabetic foot ulcers and other wounds that cannot heal on their own.
Diabetic foot ulcers and other unhealing wounds are a common complication of poorly controlled diabetes, and if neglected they can lead to a dangerous infection that can require surgery or even amputation. Anyone with diabetes can develop foot ulcers, but the good news is that they can usually be prevented with caution and proper foot care.
You can recognize diabetic ulcers by their location and appearance. These ulcers are caused by skin tissue breaking down to explore the layers beneath, possibly even all the way to the bone. They usually develop on big toes and the balls of the feet, though they can develop anywhere on the foot.
Many people who develop diabetic ulcers have lost the ability to feel pain, this means pain is not a common symptom. If you are at risk for diabetic ulcers you should watch for drainage on your socks, redness, and swelling, or if the ulcer has progressed significantly and has become infected a strong odor may be present.
Treatment Modalities
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Wound Debridement
Wound Debridement is an important part of wound healing. Debridement is the process of removing necrotic or dead tissue that occurs during wound healing. This tissue inhibits the body’s ability to recover and develop new tissue during the healing process, making debridement critical in preparing a wound for quick and efficient healing.
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Offloading
Offloading refers to removing pressure from the affected appendage. Offloading is achieved through a variety of methods. The best option for any patient will be decided by the clinician and patient together.
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Infection Control
Infection control is a critical element of any wound treatment. It can only be effective if both patient and care providers are dedicated to the proper infection control practices. Proper clinical infection control practices require the existence of an official Infection Control Program.
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Restoring Blood Flow
Poor circulation is a primary contributor to complications with wound healing. Restoring blood flow to areas showing signs of reduced circulation is critical to proper wound care and to avoid amputation.
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Advanced Wound Dressing
When caring for wounds, clinicians have a wealth of options for bandages and dressings. These options are considered superior to the basic gauze and tape and are referred to as Advanced Wound Dressings. Advanced dressings reduce heal times and decrease risk of infection, thereby reducing drainage.
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Skin Substitutes
Skin substitutes have been used to aid in wound closure for centuries. They also help to control wound pain and replace the skin functions to promote proper wound healing. Skin substitutes come in two varieties, temporary and permanent.
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Negative Pressure Wound Therapy
Negative pressure wound therapy is an option for treating burns, various types of ulcers and other chronic wounds. NPWT uses a dressing that creates a seal over the wound and around tubing which is attached to a pump which will draw out fluid and infection from a wound to help it heal.
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Total Contact Casting
A common treatment for diabetic foot ulcers relies on the application of a hard cast to relieve pressure on the areas of the foot that are most prone to ulceration. This technique is most commonly referred to as Total Contact Casting and is an option that may be presented by a provider post-diagnosis.