Wound Care

Diabetic Foot Ulcer

Diabetics have an increased risk for developing foot sores, or ulcers and these cause 15% to 20% of all hospital stays for diabetics. Diabetic foot ulcers precede the great majority of all lower leg amputations. Macro and micro vascular complications account for the increase in mortality and morbidity seen in diabetic patients over the past 20 years. Care of diabetic foot problems account for billions of dollars in direct medical expenditures in the United States and causes lengthy hospital stays and periods of disability. The surgeons at University Surgeons Associates, PC frequently treat patients with diabetic foot problems.

WHAT is a diabetic foot ulcer?

An open foot wound in a diabetic usually on the plantar (sole) surface of the foot is a diabetic foot ulcer.  These are often painless due to neuropathy.  The patients often have arterial vascular disease with some degree of ischemia.  There may be associated infection of deep tissues including tendons and bone.  

RISK FACTORS FOR DIABETIC FOOT ULCERS

  • Diabetes
  • Peripheral sensory neuropathy
  • High plantar pressure
  • Trauma
  • Deformity
  • Micro-vascular arterial disease
  • Macro-vascular arterial disease

WHAT ARE THE SIGNS AND SYMPTOMS?

  • Ulcer on sole of foot
  • Surprisingly painless
  • Drainage from ulcer
  • Redness around the ulcer
  • Swelling or redness on top of foot
  • Redness extending up the leg
  • Pain on motion of toes
  • Fever over 101 degrees F (39 C)
  • Chills
  • Skin blisters and weeping

HOW IS DIABETIC FOOT ULCER DIAGNOSED?

A full medical history of the patient is evaluated.  A wound specialist will examine the wound thoroughly and begin initial therapy.  Laboratory testing and imaging studies such as noninvasive vascular studies, X-rays, CT and MRI scans may be performed to help diagnose the problems and develop a treatment plan.  A multidisciplinary approach involving the staff of the Center, the primary care physician and specialists increases the likelihood of correct diagnosis, successful wound healing and prevention of complications or recurrence.

HOW IS A DIABETIC FOOT ULCER TREATED?

  • Debridement of the Ulcer
  • Appropriate Dressing of the Wound
  • Treatment of Infection & Inflammation
  • Control Swelling and Edema
  • Pressure Relief or “Off-Loading”
  • Protection of the Wound
  • Sometimes Surgery to Drain Pus
  • Management of Wound Pain
  • Treat Diabetes & Nutrition
  • Advanced Therapies to Stimulate Tissue Growth

WHEN TO SEE A DOCTOR

Any ulcer on the sole of the foot in a diabetic that does not heal promptly is a diabetic foot ulcer that might benefit from the specialized care available through the University Wound Care & Hyperbarics Center.  A multidisciplinary approach involving your surgeon at University Surgeons Associates, the staff of the Center, your primary care physician and specialists increases the likelihood of successful wound healing and prevention of complications or recurrence.  These difficult to heal foot ulcers frequently require weeks to months to completely heal and many of the modalities used in treatment are arduous and time consuming.  This means there must be a real commitment by the patient and their care givers to follow through with the recommendations and treatments as scheduled.  Partial or incomplete therapy almost always results in failure to heal.  The ultimate consequence of failure to heal is loss of limb or life.

If you have an established diabetic foot ulcer you should considered contacting your surgeon at University Surgeons Associates, your primary care physician or the staff of the University Wound Care & Hyperbarics Center for any of the following problems:

  • Persistent fever over 101 degrees F (39 C)
  • Pain that is not relieved by your medications
  • Chills
  • Swelling
  • Bleeding
  • The wound is larger or deeper
  • The wound looks dried out or dark
  • Purulent drainage (pus) from the ulcer
  • Redness surrounding the ulcer that is worsening or getting bigger

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