What you should know about diabetic foot ulcers.
People with diabetes can develop many different foot problems, especially diabetic foot ulcers. Even ordinary problems can get worse and lead to serious complications. Foot problems most often happen when there is nerve damage, also called neuropathy, which results in loss of feeling in your feet. Poor blood flow or changes in the shape of your feet or toes may also cause problems resulting in wounds. These wounds are often diabetic foot ulcers and we can treat them successfully here at Encompass HealthCare.
Although it can hurt, diabetic nerve damage can also lessen your ability to feel pain, heat, and cold. Loss of feeling often means you may not feel a foot injury. You could have a tack or stone in your shoe and walk on it all day without knowing. You could get a blister and not feel it. You might not notice a foot injury until the skin breaks down and becomes infected. Infections can be treated in our outpatient facility with either oral or I.V. antibiotics.
Calluses occur more often and build up faster on the feet of people with diabetes. This is because there are high-pressure areas under the foot. Too much callus may mean that you might need therapeutic shoes and inserts.
Calluses, if not trimmed, get very thick, break down, and turn into ulcers (open sores). Never try to cut calluses or corns yourself – this can lead to ulcers and infection. We can help you with your calluses. Also, do not try to remove calluses and corns with chemical agents. These products can burn your skin.
Diabetic foot ulcers occur most often on the ball of the foot or on the bottom of the big toe. Ulcers on the sides of the foot are usually due to poorly fitting shoes. Remember, even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Neglecting diabetic foot ulcers can result in infections, which in turn can lead to loss of a limb.
If your diabetic foot ulcer is not healing and your circulation is poor, we can check for (and treat) any venous insufficiency. Because diabetes causes blood vessels of the foot and leg to narrow and harden, circulation (blood flow) can make your foot less able to fight infection and to heal.
People with diabetes are far more likely to have a foot or leg amputated than other people. The problem? Many people with diabetes have peripheral arterial disease (PAD), which reduces blood flow to the feet. We can treat peripheral arterial disease right in our office! Also, many people with diabetes have nerve disease, which reduces sensation. Together, these problems make it easy to get ulcers and infections that may lead to amputation. Most amputations are preventable with regular care and proper footwear.
Debridement is the process to remove dead skin and tissue. There are many ways to do this.
- Clears away dead or necrotic tissues that can inhibit healing
- Creates a fresh wound bed to promote healing
- Re-starts the healing process
Offloading: Taking Pressure off of Your Foot Ulcer
Foot ulcers are partly caused by too much pressure on one part of your foot. Be sure to wear shoes that do not put a lot of pressure on your foot. Try not to have pressure over the ulcer too.
Your doctor may ask you to wear special shoes, or a brace or a special cast. This process is called offloading. You may need to use a wheelchair or crutches for awhile. These devices will take the pressure off of the ulcer area. This will help speed up the healing process.
The type of shoes you wear when you have diabetes is important:
- Wear shoes made out of canvas, leather, or suede. Do not wear shoes made out of plastic, or other material that does not breathe.
- Wear shoes you can adjust easily. They should have laces, Velcro, or buckles.
- Wear shoes that fit properly and have plenty of room in them. You may need a special shoe made to fit your foot.
- Do not wear shoes with pointed or open toes, such as high heels, flip-flops, or sandals.
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