Diabetic Foot Ulcers
Diabetic foot ulcers are wounds or open sores that occur on your feet. Anyone who has diabetes can develop a foot ulcer. You're also at greater risk if you use insulin, are overweight, or drink alcohol or smoke.
Diabetic foot ulcers are caused by a combination of factors, including:
- Neuropathy, or lack of feeling in your feet, caused by nerve damage that can occur with diabetes. This makes it difficult to notice irritation or pressure on your feet, which can lead to sores.
- Narrowing of blood vessels that go to your feet (peripheral artery disease).
- Foot deformities or trauma.
Patients with diabetes should examine their feet every day, looking at all areas of the feet and toes. It may help to use a handheld mirror or a magnifying mirror attached to the bathroom wall near the baseboard.
Below is a daily checklist that may be useful when examining the feet:
- Redness could point to irritation from shoes or overheating or other early signs of a problem. Do what you can to discover the cause and fix it, such as wearing shoes that fit better.
- Blue or black areas can mean bruising or blood flow problems. Call your doctor to report them.
- Bald patches may mean irritation from shoes or a blood flow problem. Show the areas to your doctor during your next visit.
- Try to discover the cause of the blister. Friction or rubbing against your skin causes blisters. You may need new shoes.
- Do not break the blister or open it yourself. Leave the skin over the blister intact.
- Cover the blister with sterile, non-stick dressing and paper tape.
- Call your doctor if any blister becomes red, oozes, or is not healing after 4 days.
Break in your skin
- Gently wash the area with mild soap; blot it dry and cover it with a sterile, nonstick dressing.
- Call your doctor if any break in the skin become red, oozes, or is not healing after 4 days.
- Be sure to examine the underside of your toes and the area between the toes for breaks in the skin.
Calluses (hardened areas of skin) and corns (pressure injuries, usually found on or between toes)
- Show the area to your doctor at your next visit; this is very important.
- Do not use products sold in drugstores to remove corns, calluses, or other problems.
- Do not use a pumice stone on calluses unless your doctor or podiatrist shows you how to use it properly.
- Do not cut, file, or do anything that may break the skin on your feet.
Peeling skin, tiny blisters between toes, or cracking and oozing of skin
- This may be athlete’s foot. Treating athlete’s foot early can prevent serious foot infections.
- To prevent athlete’s foot, wear shower shoes or bathing shoes when you use public showers or pools. Otherwise, keep feet dry.
- Keep feet clean. Wear clean socks every day.
- Do not treat athlete’s foot without first seeing your doctor.
Moisture between your toes
- Dry between your toes well. Moisture between the toes provides a good place for bacteria and fungi to grow, causing infection.
Sore or ulcer
- Do not try to treat a sore or ulcer at home. Call your doctor immediately. If you check your feet regularly, you usually will see a problem before it becomes an ulcer.
- Do not treat an ingrown toenail at home. Call your doctor for an appointment.
Checking the feet on a daily basis can help patients detect problems early. However, if someone has already noticed a wound that isn’t healing, it may be time to explore treatment options such as those offered at Forrest General’s Wound Healing Center.
Many people who get foot ulcers don't have feeling in their feet, so they don't feel pain. The first thing you may notice is redness or swelling on your foot, or a stain on your sock from the sore’s drainage.
Treatment and Healing
If you have a diabetic foot ulcer, your provider at the Wound Healing Center will prescribe an individualized treatment plan to help the ulcer heal as quickly as possible.
One of the first things we do is focused testing to properly identify the cause of the wound. Based on the results of these tests and the clinical evaluation, a treatment plan will be prescribed. The treatment plan may include:
- Routine cleaning of the wound bed
- Application of appropriate medication and dressings to the wound bed
- Application of appropriate devices to improve blood flow to the wound bed
- Application of appropriate off-loading devices to reduce pressure on the wound area
- The use of Hyperbaric Oxygen Therapy, in some situations
We provide assistance with monitoring and controlling blood glucose levels.
When the wound is healed, we will assist you with obtaining special shoes to aid in removing pressure from the feet so as to avoid the reoccurrence of another wound. We will also provide assistance with monitoring and controlling blood glucose levels.
One of our main goals is to prevent additional wounds from forming. To prevent this, we will provide education to you and your family members to aid you in avoiding the occurrence of wounds in the future.