How do you treat a diabetic ulcer?

 

 

An ulcer is a condition that can occur in any patient with diabetes. Diabetic ulcers are sores which occur typically on the foot or ankle. The ulcer is caused secondary to friction which leads to a breakdown in skin. Diabetic patients will typically have a loss of feeling in their foot and legs, so they do not feel the repetitive irritation that leads to a wound. I typically will see patients that have wounds that are caused by improper shoes, trauma, or a foot deformity that causes excess pressure over a bone.  Decreased blood flow can also lead to an ulcer and makes healing the ulcer more difficult.

 

How do you treat a diabetic ulcer?

I treat diabetic ulcers through a multi-pronged approach. On your first evaluation we will take a detailed history of the wound and perform a thorough exam of your foot/ankle. We then will develop a treatment plan to address the following issues:

Pressure: We must remove pressure which causes the breakdown of the skin. The constant pressure causes injury to the cells which are trying to fill the wound with healthy tissue and skin. We offload the wound with special padding, shoe modification, wearing special boots, or using crutches/wheel chairs to keep all weight from the foot.

Debridement: Ulcers will often have tissue which is not healthy or thick callus which is prohibiting the wound from healing. This is debrided with sterile instruments to remove any tissue which is stopping the wound from healing.

Appropriate Bandages: Applying the appropriate dressing can dramatically improve the size and appearance of the wound. There is a plethora of dressings for ulcers which all have their unique place to provide an optimal environment to heal the wound. The environment should not be too wet or too dry. I have years of experience in wound care and can prescribe the right dressing to promote wound healing.

Other Factors: We must also be diligent to look for other factors which may inhibit wound healing. I regularly perform tests to check for osteomyelitis (infection in the bone) or poor circulation. Infection and poor circulation will delay the wound healing and must be addressed to give the ulcer the best chance to heal.

Diabetic ulcers are a serious issue that need to be addressed to prevent infections and amputations. I have extensive training in diabetic wound care and limb salvage and have made this a large component of my practice. I want to work with you to treat wounds which you may have and need help to get on the pathway to healing. If you are suffering from a diabetic foot ulcer then schedule an appointment with me, S. Luke Berthelsen DPM, at my office in Vista, CA and we will get you on the road to recovery!