Diabetic Ulcers

If you have diabetes, you have an increased chance of developing foot sores, or ulcers, also called diabetic ulcers.

Foot ulcers are a common reason for hospital stays for people with diabetes. It may take weeks or even several months for foot ulcers to heal. Diabetic ulcers are often painless (because of decreased sensation in the feet).

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. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication. Ulcers can look like blisters, cuts, cracks, sores, redness, white spots or areas, thick calluses, discoloration, or other changes. Don't rely on pain; even feeling more warmth or cold than usual can be a sign that you have an open wound on your skin, and it's possible that you may feel nothing at all.

Debridement

One way to treat an ulcer is debridement. This treatment removes dead skin and tissue. You should never try to do this yourself. A provider, such as a podiatrist, will need to do this to make sure the debridement is done correctly and does not make the injury worse.

• The skin surrounding the wound is cleaned and disinfected.
• The wound is probed with a metal instrument to see how deep it is and to see if there is any foreign material or object in the ulcer.
• The provider cuts away the dead tissue, then washes out the ulcer.
• Afterward, the sore may seem bigger and deeper. The ulcer should be red or pink. Wounds that are pale or purple/black are less likely to heal.

Other methods the provider may use to remove dead or infected tissue are:

• Put your foot in a whirlpool bath.
• Use a syringe and catheter (tube) to wash away dead tissue.
• Apply wet to dry dressings to the area to pull off dead tissue.
• Put special chemicals, called enzymes, on your ulcer. These dissolve dead tissue from the wound.
• Order hyperbaric oxygen therapy (helps deliver more oxygen to the wound).

Negative Pressure

Foot ulcers are partly caused by too much pressure on one part of your foot.

Your provider may ask you to wear special shoes, a brace, or a special cast. You may need to use a wheelchair or crutches until the ulcer has healed. These devices will take the pressure off of the ulcer area. This will help speed healing.

Sometimes putting pressure on the healing ulcer for even a few minutes can reverse the healing that happened the whole rest of the day.

Be sure to wear shoes that do not put a lot of pressure on only one part of your foot.

• Wear shoes made of canvas, leather, or suede. Don't wear shoes made of plastic or other materials that don't allow air to pass in and out of the shoe.
• Wear shoes you can adjust easily. They should have laces, Velcro, or buckles.
• Wear shoes that fit properly and are not too tight. You may need a special shoe made to fit your foot.
• Don't wear shoes with pointed or open toes, such as high heels, flip-flops, or sandals.

Diabetic ulcers can be very dangerous if you are unaware of the real damage they can cause. Call or click to schedule an appointment today!