What Is Wound Care?

A wound occurs when the internal tissue is exposed to the skin, due to an external or internal injury. Most people conduct wound care at home but consult a podiatrist for proper diabetic wound care. Seek diabetic foot ulcer treatment from a podiatrist to avoid the development of complications that may lead to hospitalization of patients. Foot ulcers for diabetic patients can lead to amputation if wound care treatment is not well done.

Wound care treatment

There are basic principles for wound care; ensure you wear protective gear when attending to a wound.

1. Hemostasis – Applied to significant wounds with bleeding to stop the bleeding. The bleeding is stopped by reducing the bleeding or aiding the hemostasis process. Some of the techniques used include elevation, suturing, pressure, or tourniquet.
2. Cleaning the wound – This promotes healing and reduces the infection. Five main steps of wound cleaning are
   1. Disinfect all around the wound without getting detergents and alcohol into the injured area.
   2. Decontaminate by removing foreign bodies from the wound.
   3. Debride any tissues around the wound.
   4. Wet the wound with saline if no obvious contamination can be seen. Saline should be stored in a sterile container.
   5. For heavily soiled wounds, open foot fractures, puncture wounds, and animal bites use antibiotics. It is advisable to introduce antibiotics at the first sign of wound infection.
3. Skin closure – This aids the wound healing using skin adhesive strips, tissue adhesive glue, sutures, and staples are some skin closure techniques for the edge of the wounds.
4. Dress the wound – This effectively reduces contamination and infection of the injury. When dressing, the first layer should be saline-soaked, followed by an absorbent material layer to attract wound exudates. Finally, use a soft gauze to secure the dressing in place. It is advisable to get tetanus immunization if not already done.

Diabetic foot ulcer treatment

Patients using insulin are at a higher risk of developing a foot ulcer.  Also, for overweight people or people who use alcohol and tobacco the risk is high. A diabetic foot ulcer develops due to lack of feeling in the foot, trauma, foot deformities, and irritation. Pain may not be felt by diabetic patients. Seek podiatric medical care for diabetic foot ulcer treatment. This reduces the risk of wound infection leading to amputation. To appropriately treat a diabetic foot ulcer, ensure that you:

• Prevent infections.
• Offload or take the pressure off the wound.
• Regularly remove dead tissue and skin from the wound.
• Apply dressing and medication to the ulcer.
• Manage blood glucose under tight control to avoid ulcer infection.
• Clean the wound daily and dress it.
• Ensure adequate circulation on the ulcerated area with the help of a podiatrist.
• Surgical treatment – If other ulcer treatments are not effective, surgical management may be used to correct deformities and shave or excision the bone.

The time needed for healing depends on different factors including wound care management used and the diabetic foot ulcer treatment used.
Over at DeNiel Foot and Ankle Center  located in Houston, Texas, and covering surrounding areas like Cypress, and Katy, TX. Ejodamen Shobowale, DPM and her highly skilled staff provide personalized comprehensive care for all your podiatry and sport medicine needs. Whether the issue is foot-related like hammertoes, or toenail fungus or involves pain in the heel , nerves, or joints, Dr. Sho, as she is fondly called, can get you back on your feet in no time.

The importance of eating a healthy, balanced diet, monitoring blood glucose levels, staying active, and taking prescribed medications can never be emphasized enough if you are diabetic; another important thing to add is regular foot exams. Foot exams reduce the chances of developing complications as a result of conditions that were not attended to early. There are self-exams and annual professional evaluations. Diabetes presents a high risk of foot problems such as diabetic foot ulcers and peripheral vascular disease to patients. Diabetic foot care looks out for injuries, infections or bone abnormalities. The main cause of diabetic feet problem is nerve damage and poor blood flow or blood circulation.

Alarming symptoms which require attention include 

• Burning sensation
• Tingling
• Pain
• Difficulty while walking
• Numbness
• Swelling

Symptoms that call for the immediate attention of a podiatrist include

• A cut or a blister that is taking longer to heal.
• If an injury is warm to touch
• If an injury has redness around it.
• The presence of callus with dried blood inside.
• And a smelly, black injury which most likely is gangrene; this is the death of body tissue and if left untreated could lead to foot amputation or death.

What to expect when a podiatrist examines you

1. General assessment where the podiatrist asks questions about your health and any problems you have had with your feet. They also ask about your footwear to be sure your shoes do not easily cause blisters, calluses, and ulcers.
2. Dermatological assessment where the podiatrist will look for skin problems and signs of fungal infection.
3. Neurologic assessment that includes a series of tests which are
   1. Monofilament test which particularly tests foot sensitivity.
   2. Tuning fork and VPT (Visual Perception Tests) – to check the sensitivity of the foot and toes to vibrations.
   3. Pinprick test to determine if you can feel a pin, poke your foot.
   4. Ankle reflexes – a tap below the knee to check your reflexes.
4. Musculoskeletal assessment to check for abnormalities in the structure and shape of your foot.
5. Vascular assessment using the Doppler ultrasound to check how well the blood is flowing to your feet.

Treatment

The provider might recommend frequent exams to monitor the progress, but for bone deformities, surgery can be recommended while antibiotics are administered to treat foot infections.

No specific treatment is administered for nerve damage, but treatments are given, such as skin creams, medicine, and physical therapy, to improve the function of the feet and relieve pain. 

How to go about diabetic foot care?

Wear appropriate fitting shoes or ask the doctor for custom shoes.

Keep moist away from your skin by wearing socks.

Clean your feet daily and apply a fragrance-free moisturizer, avoid applying in between the toes.

Trim toenails regularly

Avoid walking barefoot

Conduct daily foot self-exams to monitor changes.

Seek professional foot evaluation at least annually.

Manage diabetes as recommended by the health professional.

Avoid abrasive foot products

Exercise daily to keep the blood flowing.

Do not smoke as this leads to foot complications due to poor blood circulation and nerve damage.