A diabetic foot ulcer is an open sore or wound that appears on the bottom of the foot and may lead to amputation if not treated quickly.
Two complications from diabetes contribute to foot ulcers:
- Neuropathy, or nerve damage, reduces the sensation in the extremities. A small cut, bruise or puncture wound may not be noticed and can worsen into a sore.
- Poor circulation caused by excess blood sugar can inhibit healing blood flow to the feet.
Foot deformities, irritation from pressure or friction such as from wearing inappropriate shoes, and trauma can cause the formation of ulcers too.
Symptoms
Pain is not a common symptom because of accompanying neuropathy. But you may notice:
- An open sore
- Drainage on socks
- Redness
- Swelling
- Unpleasant odor
It’s essential to seek out a podiatrist’s help immediately if you notice an ulcer.
Treatment
Our goal is healing the ulcer as soon as possible to reduce the chance of an infection. To do this, we will take pressure off the area, remove dead skin and tissue and apply medication and dressing.
Using a brace or specialized castings, wearing special footgear or using crutches or a wheelchair can help reduce pressure and irritation.
Wound management includes keeping the area covered and moist. We will apply topical medication and dressings. We will assess blood circulation levels with non-invasive tests.
We may recommend surgery if other measures to heal the ulcer are not successful. A surgical goal would be to relieve pressure on the affected area.
Complete healing of an ulcer in a patient with diabetes may take weeks or even several months.
Prevention
Preventing an ulcer from developing is its best treatment:
- Visit your podiatrist regularly for comprehensive foot exams.
- Check your feet every day, especially the soles (ask for someone’s help or use a mirror) and between the toes. Look for any changes in the skin such as a cut, bruise, blister, crack, sore or redness.
- Keep blood sugar levels under control.
- Wear appropriate shoes that are supportive, roomy and comfortable.
- Reduce risk factors such as smoking, drinking alcohol and high cholesterol.