What Does A Diabetic Foot Ulcer Look Like

Can Diabetic Foot Ulcers Heal

How Common Are Diabetic Foot Ulcers

What Can You Put On A Diabetic Foot Ulcer

Alginate and foam dressings provide high absorbency for moderate to heavy exudate. For a diabetic foot ulcer with dying tissue, hydrogels or dressings with collagen and silver are most effective. Most important is matching the absorptive ability of the wound dressing to the amount of wound drainage.

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Clinical Pathways And Assessment Forms For Diabetic Foot

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What Are The Signs And Symptoms Of Diabetic Foot Ulcers

Foot ulcers are open sores or wounds that occur most often on the ball of your foot or on the bottom of your big toe. They may also develop on the side of your foot, usually because of poorly fitting shoes. The ulcers are usually painless. Not all diabetic foot ulcers become infected but people with diabetes are at high risk of developing infection of the ulcer and the surrounding skin .

Depending on the severity of the wound and the presence of infection, diabetic foot ulcer can be classified in 4 ways:

• Uninfected the wound does not have signs of infection.
• Mild infection the area around the wound may be warm to the touch, red, slightly swollen, painful or tender, and the wound may ooze pus.
• Moderate infection foot infection that involves the deeper layers of your skin, into the muscle, tendons, bone or joints.
• Severe infection foot infection that causes . The symptoms of sepsis are high body temperature , fast heartbeat, and heavy or quick breathing.

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Who Can Get A Diabetic Foot Ulcer

Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics and older men are more likely to develop ulcers. People who use insulin are at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.

Treatment For Diabetic Foot Ulcers

If a diabetic foot ulcer does occur, its important to seek medical care as soon as possible this is not a wound you should attempt to treat at home on your own. The faster a foot ulcer is properly treated, the greater chance it will heal completely and without infection or complications.

A diabetic wound care specialist, such as the Wound Care Center at Harrington, can provide the most advanced and comprehensive diabetic wound treatment. Your primary care physician can provide a referral to the wound care center. Our Wound Care Center team will then continue working hand-in-hand with your doctor throughout the wound treatment process.

Our specialized diabetic wound treatment services include:

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What Causes Diabetic Foot Ulcer

People with diabetes have an increased chance of developing foot ulcers because you are more likely than other people to damage the skin on your feet. This is because diabetes can cause nerve damage, so you don’t notice if your foot is injured or sore. Diabetes also causes blood vessel damage so your skin can’t heal easily.

When To See A Dermatologist

Diabetes can cause many other skin problems. Most skin problems are harmless, but even a minor one can become serious in people who have diabetes. A board-certified dermatologist can recognize skin problems due to diabetes and help you manage them.

Are all dermatologists board certified?

No. See what it takes to become board certified.

ImagesImage 1: Image Courtesy of Clark C. Otley, MD. All Rights Reserved

Images 3, 7, 8, 9: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2 from DermNetNZ

Some images used with permission of Journal of the American Academy of Dermatology

ReferencesCohen Sabban, EN. Cutaneous manifestations of diabetes mellitus from A to Z. Focus session presented at: 74th Annual Meeting of the American Academy of Dermatology March 4-8, 2016 Washington D.C.

Duff M, Demidova O, et al. Cutaneous manifestations of diabetes mellitus. Clinical Diabetes. 2015 33:40-8.

Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:1461-70.

McKinley-Grant L, Warnick M, et al. Cutaneous manifestations of systemic disease. In: Kelly AP and Taylor S. Dermatology for Skin of Color. . The McGraw-Hill Companies, Inc. China, 2009:481-4.

Morgan AJ and Schwartz RA. Diabetic dermopathy: A subtle sign with grave implications. J Am Acad Dermatol. 2008 58:447-51.

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Is Diabetic Foot Curable

Diabetic foot infections are a frequent clinical problem. About 50% of patients with diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches.

What Does The Start Of A Diabetic Foot Ulcer Look Like

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How Long Does It Take For A Diabetic Foot Ulcer To Heal

The nature of the diabetic ulcer of the foot will determine how much time it will need to heal. If it is mild, it may heal on its own in as little as three weeks. More severe ulcers will take months to heal.

Additionally, blood sugar plays a part in healing wounds. People living with diabetes may have a more challenging time healing, in general, due to their fluctuating blood sugar levels. Therefore, healing diabetic ulcers of the foot may have more success healing when treated by a wound care specialist.

What Do Ulcers Look Like

Ulcers are wounds in your skin shaped like circles or ovals and can vary in size and color. When an ulcer starts you may notice:

• Dry skin.
• Redness.
• A rash.

As the ulcer gets worse, it can get wider, longer and deeper sometimes all the way down to the bone. In advanced stages you may see:

• A callus.
• A halo around the center that gets hard.
• Drainage in your sock, which may mean you have an infection.
• A brown discoloration.

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What To Do If You Notice A Problem

The signs of diabetic ulcers on the foot should never be left untreated. If you have any of the symptoms mentioned above or think you might have a foot sore or ulcer, you should be seen by a doctor as soon as possible to avoid further damage and possible infection. The earlier you seek medical help, the less chance of complications further down the line.

Here at the Midwest Institute for Non-Surgical Treatment , we have qualified podiatrists who can provide you with the right treatment for your diabetic foot ulcer. We’ll also advise you on how best to look after your feet to prevent reoccurrences.

Book an appointment with Dr. Akinwande and the team who can treat you at one of our convenient locations in the St Louis area. Call us today, and we’ll get you back on your feet and the path to recovery.

Foot Ulcer Prevention Tips You Should Consider

People with diabetes and others who know they are at risk for foot ulcers should examine their feet daily and practice good foot hygiene.

Those with foot ulcers should keep the wound clean and dry, change the dressing as directed, take prescribed medications, maintain a healthy diet, and wear appropriate shoes.

Medical References:

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Diabetic Foot Ulcers: Prevention Diagnosis And Classification

DAVID G. ARMSTRONG, D.P.M., and LAWRENCE A. LAVERY, D.P.M., M.P.H., University of Texas Health Science Center at San Antonio and the Diabetic Foot Research Group, San Antonio, Texas

Am Fam Physician. 1998 Mar 15 57:1325-1332.

See related patient information handout on maintaining healthy feet in diabetics, written by the authors of this article.

• References

Diabetic foot complications are the most common cause of nontraumatic lower extremity amputations in the industrialized world. The risk of lower extremity amputation is 15 to 46 times higher in diabetics than in persons who do not have diabetes mellitus.1,2 Furthermore, foot complications are the most frequent reason for hospitalization in patients with diabetes, accounting for up to 25 percent of all diabetic admissions in the United States and Great Britain.35

The vast majority of diabetic foot complications resulting in amputation begin with the formation of skin ulcers. Early detection and appropriate treatment of these ulcers may prevent up to 85 percent of amputations.6,7 Indeed, one of the disease prevention objectives outlined in the Healthy People 2000 project of the U.S. Department of Health and Human Services is a 40 percent reduction in the amputation rate for diabetic patients. Family physicians have an integral role in ensuring that patients with diabetes receive early and optimal care for skin ulcers.

Demographic And Clinical Variables

Demographic and clinical variables which were considered to be potential confounders were sex, age, HbA1c, coronary disease, vascular surgical treatment, and neuropathy. These variables were selected based on previous literature and clinical judgement. Age was defined as the age at first consultation at the outpatient clinic. HbA1c measurements were reported in the International Federation of Clinical Chemistry units in addition to derived NGSP units upon attendance at the outpatient clinic. Coronary disease was defined as having angina pectoris, history of myocardial infarction, previous coronary angioplasty or artery coronary bypass operation. Vascular surgical treatment includes information on percutaneous transluminal angiography of the peripheral arteries or bypass. Neuropathy was defined as an abnormal pressure sensation evaluated with the 10-g monofilament .

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How Your Feet Are Affected By Diabetes

You may experience a few or several of the following problems due to diabetes: Athletes foot: It is a condition in which fungus starts to grow between the toes of your feet. Calluses: It involves the formation of hard skin on the underside of the feet. Corns: It is the formation of hard skin on the bony sides of the toes or in between the toes.

Why Do Diabetics Get Foot Ulcers

Not all people living with diabetes get foot ulcers. However, if diabetes goes untreated or is managed poorly, issues like diabetic ulcers of the foot tend to be more common. Diabetic ulcers of the foot happen when the foot does not get proper circulation, and a combination of high blood sugar, irritated skin or tissue in the feet, and damaged tissue all combine to create the perfect conditions for foot ulcers.

Often, diabetic ulcers of the foot go unnoticed due to poor circulation and are only noticed after drainage, discoloration, and lumps form on the feet.

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How Are Diabetic Foot Ulcers Treated

How To Treat Ulcers

If you do get an ulcer or notice a change in your skin that youâre not sure about, tell your doctor right away. Youâll likely get a procedure called debridement, which removes unhealthy tissue from the wound to spur healing.

Your doctor will also work with you to try to keep your sore or ulcer from getting infected and becoming bigger. Some of the steps they may recommend include:

Clean your ulcer daily. Use soap and water, unless your doctor recommends another cleanser. Donât use hydrogen peroxide or soak your wound in a bath or whirlpool, because this could reduce healing and may boost your odds of infection.

Keep your ulcer bandaged or covered with a wound dressing. While you may have heard that itâs important to âair outâ wounds, experts now know that not covering a wound actually increases the odds of infection and slows healing.

Keep pressure off your ulcer, especially if itâs on your foot. This may mean you need to use crutches, special footwear, a brace, or other devices. Reducing pressure and irritation helps ulcers heal faster.

Use the topical medications your doctor recommends. These may be saline, growth factors, and/or skin substitutes.

Keep your blood sugar under control. In addition to reducing your risk of ulcers, tight blood sugar control helps your body heal existing ulcers.

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What Are The Treatments For A Diabetic Foot Ulcer

Dr. Griffin performs comprehensive neurologic, vascular, and orthopedic exams and uses the latest cutting-edge techniques and treatment methods to treat diabetic foot ulcers.

She might suggest a number of treatment methods, such as:

• Antibiotics, if an infection is present
• Use of mechanical offloading to reduce pressure areas
• Debriding agents, synthetic skin substitutes, and medical dressings
• Topical wound care therapies

How To Spot The Signs Of A Diabetic Ulcer On The Foot

A foot ulcer is one of the most common and serious complications for people with diabetes, occurring in approximately 15% of patients, according to the American Podiatric Medical Association. Diabetic ulcers on the foot can occur in anyone with type 1 and type 2 diabetes and refer to an open sore on the foot, usually forming under big toes and at the bottom of feet. The main reasons people with diabetes develop foot ulcers are:

• Trauma or injury to the foot
• Poorly fitting shoes
• Poor blood flow to the foot
• Increased pressure to the foot
• Nerve damage which means you are unable to feel your feet properly

If you’ve had a diabetic ulcer on the foot for a long time, you are at greater risk of infection, which can spread from the wound to the bone. While there are antibiotics that can treat these infections, if too much bone has been damaged, the foot will have to be removed or amputated.

Therefore patients and caregivers need to be able to identify these types of wounds to prevent them from getting worse. So how do you know if you have a diabetic foot ulcer?

If the ulcer is at an advanced stage, it should be obvious. A foot ulcer looks like a round red crater in the skin bordered by thickened callused skin. Severe ulcers can be deep enough to expose tendons or bones. However, other symptoms may not be easy to identify or could be an indication of another problem. That being said, here are some of the common signs of diabetic foot ulcers to look out for.

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Foot Ulcer Treatment Using A Hyperbaric Oxygen Chamber

A highly successful way of treating diabetic ulcers of the foot has been through hyperbaric oxygen chambers. Hyperbaric oxygen chambers increase circulation, blood oxygen levels and promote angiogenesis among foot ulcer patients healing processes that are often stunted due to diabetes.

Foot ulcer treatment using hyperbaric oxygen chambers is relatively simple but has been shown to decrease the time that patients suffering from diabetic ulcers of the foot take to heal.

Typically, patients receive at least ten hyperbaric oxygen therapy treatments, and they may receive HBOT treatments up to five times per week.

How Can Diabetic Foot Ulcers Be Prevented

Looking after your feet can help prevent foot ulcers and avoid serious complications. Good foot care includes checking your feet every day, keeping them clean and dry, wearing proper footwear and trying to avoid doing things that could damage them.

Get a foot check at every healthcare visit and seek urgent medical advice if you notice a cut, ulcer or other injury on your foot.

Learn more about diabetes and foot care.

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