At Advanced Podiatry we see our fair share of diabetic foot problems. Diabetic ulcerations (openings in the skin) are one problem we take very seriously since poor management of the wound can lead to unnecessary surgery. This blog will discuss key elements in treating diabetic foot ulcers.
Diabetes can affect the way the nerves function in the body which typically results in a lack of feeling to the hands and feet of the patient. This is called diabetic peripheral neuropathy. Patient’s will often complain that they feel numbness and tingling in their feet. Sometimes the damage to the nerve can be so severe that walking is difficult because the nerves that control the muscles of the foot are damaged.
When the foot is insensate (numb), the patient is not able to tell if they are stepping on something sharp. The normal reaction to pull the foot away from the painful stimuli is absent due to the neuropathy. The injury results in an open wound and will require immediate medical attention. In addition to trauma, diabetic foot ulcers can also be caused by excess pressure to an area on the foot.
To heal these wounds we need four key elements. The first key is circulation (blood flow) to the foot. In nature, grass needs water to attain the necessary nutrients for growth. The same can be considered with blood supply to the skin. Blood has nutrients and growth factors that allow the skin to repair itself and grow. If there is a lack of circulation, then the wound will take a prolonged time to heal or may not even heal at all. If the patient is suffering from poor circulation to the feet, we can check the severity of the problem with a simple pressure test. At Advanced Podiatry, we have a non-invasive and painless way of checking blood flow to the foot. The test takes approximately 20 minutes and will give the doctor an idea of how good the circulation is. If there is a severe case of poor blood flow, then the patient may be referred to a vascular doctor for further treatment. Blood is a major component to healing and we will utilize other specialties to attain proper flow to get the ulcer healed.
The next key component is getting rid of any infection. Anytime an open wound occurs on the body it is possible that infection may occur. The foot will typically look red, hot, swollen, and have drainage coming from the wound. Diabetic foot infections are a problem since diabetics in general have a hard time healing. The immune system in diabetics is weakened, and as a result, infections can occur more frequently in diabetic patients. The doctor will carefully examine your wound and will determine if there is an infectious component to the wound. If so, oral or topical antibiotics will be utilized in order to get rid of the infection. The doctor may also take a culture of the wound in order to pick the most effective antibiotic. The course of the antibiotics will be anywhere from 7-10 days depending on the severity of the infection. If intravenous antibiotics are needed, then the patient will be referred to an infectious disease specialist for their antibiotic therapy. If the infection persists or is left untreated then the infection can spread to the bone which can lead to amputation of the limb. Therefore, getting rid of the infection is one of the key elements in fighting diabetic wounds.
Offloading is the final key to healing diabetic ulcers. Keeping pressure off of the wound is necessary since the physical pressure caused by walking on the wound can prevent healing. When the body is trying to heal a wound it attempts to lay down scaffolding to grow skin across the wound. The weight of the body is enough to destroy the bodies’ attempt to heal itself since the scaffolding is broken apart by the weight of walking. This is why diabetic shoes are so important. Custom diabetic inserts can be used to offload the weight of the foot by dispersing the weight evenly. If the pressure is lessened, then the healing can occur more efficiently. Sometimes the doctor will prescribe a surgical shoe or boot which has cut outs on the insert to float the area of the wound.
The happiness and well being of our patients is the most important aspect of Advanced Podiatry. We strive to be the best at what we do and our wound care skills are excellent. We stay current with all the top strategies and products for wound healing and continue to educate ourselves throughout the years. At Advanced Podiatry, we have a large selection of wound care products that can be given to the patient to aid in the healing process of the wound. These products can be made easily available to the patient at their appointment.
Diabetic foot wounds is a serious problem and we encourage patients to check their feet daily for any opening or sore on the skin. Treating the problem early will prevent surgical intervention and will preserve the active lifestyle of the patient. Protecting the feet by wearing socks with slippers/shoes at all times will help to prevent any trauma to the feet and thereby decrease the risk of ulceration. Seeing your podiatrist regularly for a diabetic foot check-up is also a very good way to help prevent wound complications.
Please make an appointment today at Advanced Podiatry by calling 813-875-0555. Let us help you heal your foot problems quickly and effectively.