A diabetic foot ulcer may begin like a normal wound. It might be a cut, scrape, blister, or other minor injury. Unlike normal wounds that heal naturally over a few days, a diabetic wound fails to heal properly.

In diabetic patients, these poorly-healing wounds can be associated with two major complications:

Neuropathy

Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of sensation due to nerve damage. A common symptom of neuropathy is numbness, which causes a diminished ability to feel discomfort and pain. As a result, a patient suffering from neuropathy will not necessarily be aware that they have a cut or a blister, even if it means a potential harm to the body.

Peripheral Vascular Disease

The risk of getting peripheral vascular disease is increased in diabetic patients, since high blood sugar damages and weakens blood vessels. Peripheral vascular disease often results to a decreased blood flow to the legs and feet. If you have a wound, consistently strong circulation is important to help red blood cells deliver nutrients for faster healing. Without strong circulation, diabetic patients become even more vulnerable to infections.

Prevention of Diabetic Foot Ulcers

Non-healing foot ulcers are proven to be preventable in a number of ways:

1. Visit your endocrinologist regularly.

To better manage your diabetes, an endocrinologist can help by monitoring your Hemoglobin A1C (HbA1C) test, which is a three-month average of your blood sugar level. They will also check your feet, make sure you have good circulation, and address any problem you may have encountered since the last visit.

2. Check your blood sugar everyday.

Regular blood sugar monitoring is the most important thing to do when managing diabetes. It can help you record changes in your blood sugar levels and identify which activities affect them.

3. Avoid walking barefoot.

Wearing house slippers is a good way to protect your feet. Socks are not enough because some objects can easily pierce through it and hurt your feet.

4. Check for foreign objects inside your shoes.

Before wearing your shoes, make sure that they are free from any foreign object. This might be a stone, a tack, or anything that can cause an injury to your foot.

5. Inspect your feet before going to bed.

Regularly check for wounds or red areas on your feet and in between your toes. If the patient is unable to perform this task themselves, a family member should be taught how to assess foot health.

Treatment of Diabetic Foot Ulcers

If you notice or suspect a non-healing wound on your foot, it is important to seek podiatric care immediately. Diabetic wounds are not the type of wound to be treated at home on your own.

Early diabetic wound treatment is vital to reduce the risk of infection and amputation, improve function and quality of life, and reduce healthcare costs.

Specific measures include:

• Debridement

This process involves the removal of dead and infected tissue. Debridement can also expose the real wounds and help your doctor evaluate the extent of your injuries.

• Off-loading

Patients may be asked to use crutches, special footwear, a brace, or other devices. Reducing pressure and irritation helps ulcers heal faster.

• Medication and Dressing

Appropriate wound management includes the use of dressings and topically-applied medications. These may be saline, growth factors, or skin substitutes that have been shown to be highly effective in healing foot ulcers.

• Hyperbaric Oxygen Therapy (HBOT)

The oxygen-rich environment in the HBOT chamber allows cells to take oxygen to the wound more efficiently and helps to kill the bacteria in infected wounds.

• Surgical Options

In cases when non-surgical treatments do not work, a surgeon can help alleviate pressure around your ulcer by shaving down the bone or removing foot abnormalities such as bunions or hammertoes.

Look no further if you have a non-healing foot ulcer and want to get treated by one of the best foot and ankle doctors in Houston, TX. DeNiel Foot & Ankle Center‘s podiatrist is well-equipped to treat all sorts of diabetic foot wounds. If you’re looking for a new foot specialist, give them a call to set up an appointment.

The post How To Manage Non-Healing Foot Ulcers In Diabetic Patients appeared first on DeNiel Foot and Ankle Center - Ejodamen B Shobowale, DPM.

Stages of wound healing

Stage I: Inflammatory stage, which is the first stage of the wound formation and it, attempts to restore normal state by forming blood vessels to control bleeding. At this stage, the wound appears red, swollen and is warm.

Stage II: The proliferative stage lasts about 3 weeks or longer depending on the severity of the wound. This is granulation where special cells known as fibroblasts make collagen fill the wound. New blood vessels start to form and a layer of skin gradually covers the wound.

Stage III: Remodeling and maturation stage can last up to two years. New collagen changes the skin around the wound forming a scar that is almost as strong as the original tissue.

Causes of nonhealing wounds

1. Infections by bacteria colonization which slows down the healing process of the wound.
2. Excess use of antibiotics has been cited as a problem leading to non-healing wounds.
3. Microbiology such as arterial insufficiency, pressure and venous insufficiency that reduces the capacity of the skin to repair itself causing a non-healing wound.

Wound care treatment

Wound treatment is effective because it promotes wound healing and reduces the risk of infection.  If you are looking for some expert advice on wound care, you may want to seek help from a podiatrist. Feel free to contact our office to make an appointment with our podiatrist. Our foot and ankle specialist, Dr. Ejodamen Shobowale can provide you with the care you need to keep you pain-free and on your feet

1. Debridement

Debridement is the process of removing damaged or dead tissue and foreign objects from the wound.

Types of wound debridement

Biological debridement uses sterile maggots that digest the dead tissue and pathogens of the wound, giving space to the formation of new cells.

Enzymatic debridement uses a topical agent to chemically liquefy necrotic tissues with enzymes, which devitalize the tissues within the wound. This method can be used together with surgical debridement.

Autolytic debridement is long-term and works by maintaining moisture beneath a wound’s dressing using the body’s enzymes. Dressing absorbency is important in the maintenance of moisture.

Mechanical debridement by hydrotherapy technique and wet-to-dry dressing is cost-effective though it can cause damage to healthy tissues. The wet-to-dry dressing is changed every 4 to 6 hours.

Conservative sharp and surgical debridement is performed by a skilled practitioner who removes the biofilm and devitalized tissue. The level of debridement is determined by the level of tissue removal.

1. Nutritional supplements

Vitamin C and Aloe Vera through research have been found to play an active role in wound healing. Most diets are deficient in nutrients that enhance healing in the body. Vitamin C stimulates the immune system by increasing amino acid arginine, which activates metabolic functions to stimulate the cells to protect against bacteria. Aloe Vera can be applied or taken for internal wounds, it provides micronutrients that reduce pain and inflammation, and prevent infections. Turmeric has antioxidant properties that decrease inflammation and encourage healing by transforming the growth factor. Pineapples have a proteolytic enzyme that dissolves proteins and works best for wounds with too much scar tissue.

Seek wound care specialist services if the wound is split open and may need stitches when pain is severe and does not get better after taking painkillers and in case the wound is deep or it covers a large area. Seek immediate attention if the area around the wound looks infected. If you have any questions, please feel free to contact our office located in Cypress, TX. Our Cypress office can handle all of your wound care issues. We will provide you with the latest diagnostic and treatment methods for all wound-related issues.

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