Wound Care for Diabetic Foot Ulcers: A Comprehensive Guide
Diabetes is a chronic condition that can lead to serious complications, one of the most severe being diabetic foot ulcers (DFUs). These open sores or wounds typically develop on the bottom of the foot and, if left untreated, can lead to severe infections or even amputations. Proper wound care is essential for managing and healing diabetic foot ulcers effectively. The podiatrists at Albuquerque Associated Podiatrists are specialists in diabetic foot care and offer same-day appointments to allow expedient care for these time-sensitive issues. This article explores the causes, risks, treatments, and best practices for caring for these wounds, as well as the distinction between ulcers and wounds.
Ulcers are chronic and typically caused by underlying medical conditions, while wounds are acute caused by external injury such as trauma. All ulcers are wounds, but not all wounds are ulcers.
Wounds are acute injuries caused by external factors like trauma, burns, or surgery. They usually heal quickly with proper care. Ulcers, on the other hand, are chronic, slow-healing sores caused by conditions like poor circulation, prolonged pressure, or diabetes-related complications. Unlike simple wounds, ulcers require specialized treatment to prevent infection and promote healing. Ulcers often appear as deep, irregular sores, while wounds can range from minor cuts to deep lacerations. In short, all ulcers are wounds, but not all wounds are ulcers. Understanding this difference is crucial for proper treatment.
Diabetic foot ulcers are primarily caused by:
Neuropathy (Nerve Damage): High blood sugar levels can damage nerves, reducing sensation in the feet. Without pain perception, minor cuts or blisters can go unnoticed, worsening over time. Usually if the feet are completely numb, then the damage has been done and it is not reversible. However if the patient experiences some pain and some numbness, it is possible to prevent further nerve damage and improve the pain with good blood sugar control.
Poor Circulation: Diabetes can damage blood vessels, leading to poor circulation, which slows healing and increases the risk of infection. It is normal for an arterial duplex ultrasound to be ordered by a podiatrist to evaluate the circulation, and it may require a referral to vascular surgery for consultation.
Infection and Immune Dysfunction: Diabetes weakens the immune response, making it harder for wounds to heal and easier for infections to spread. This could be improved with good blood sugar control.
Foot Deformities and Pressure Points: High-pressure areas on the foot, caused by ill-fitting shoes or deformities like bunions, can lead to ulcers. Foot doctors often work closely with prosthetists and prescribe custom orthotics, shoes, and braces.
Proper infection control is crucial for preventing complications from diabetic foot ulcers. The following strategies can help minimize infection risk:
Early Detection: Regularly inspect the wound for signs of infection, including increased redness, swelling, warmth, pus drainage, foul odor, or worsening pain.
Antibiotic Use: Mild infections may be treated with topical antibiotic ointments, while moderate to severe infections may require oral or intravenous antibiotics, as prescribed by a healthcare professional.
Debridement: Removing dead or infected tissue through medical debridement can promote healing and reduce bacterial load.
Proper Wound Dressing: Keeping the wound covered with sterile dressings prevents contamination and maintains an optimal healing environment.
Blood Sugar Control: Maintaining stable blood sugar levels helps boost the body's immune response, improving the ability to fight infections and heal wounds effectively.
Professional Medical Attention: If an infection worsens or does not improve with basic care, seeking professional podiatric evaluation is essential. The specialists at Albuquerque Associated Podiatrists offer same-day appointments to manage infections promptly.
Oral or Intravenous Antibiotics: A recent randomized controlled trial called the "OVIVA" trial gave support for treatment of complex bone and joint infections with oral antibiotics. This gave support for our wound care specialists to treat complex diabetic foot problems such as osteomyelitis without hospitalization or amputation.
For individuals managing minor wounds at home, the following step-by-step regimen can help ensure safety and promote healing:
Wound Sprays: Use a wound cleansing spray designed for removing debris and bacteria.
Soap and Water: Simple soap and water in a clean bucket is also an effective way to cleanse minor wounds.
Hydrogen Peroxide: Can be used for contaminated wounds when necessary; however, it should not be utilized as a routine cleansing agent, as its strong oxidative properties can harm healthy tissue and potentially impede the healing process.
Betadine (Povidone-Iodine): Safe to use twice a week to keep wounds clean and free from infection.
Antibiotic Ointment: Use an over-the-counter antibiotic ointment, such as Neosporin, for daily application to prevent infection.
Band-Aids: Ideal for small wounds no more than 2 cm.
Gauze and Tape: Suitable for covering larger or deeper wounds greater than 2 cm, ensuring proper coverage based on the wound’s location and size.
Kling or Kerlix: Excellent supportive dressings to help wrap and secure gauzes. Kling is recommended for most wounds, while Kerlix is preferred for larger or more heavily draining wounds.
Moist Wound Healing: Avoid letting the wound dry out completely; a moist environment promotes faster healing.
Diabetic foot ulcers are a serious complication that requires immediate attention and proper wound care. With early intervention, proper medical treatment, and preventive measures, the risk of infection and amputation can be significantly reduced.
At Albuquerque Associated Podiatrists, we are leaders in advanced wound care and debridement techniques. Our board-certified podiatrists are nationally recognized experts in the field, frequently lecturing at prestigious conferences such as the Symposium on Advanced Wound Care (SAWC) and the American Diabetes Association (ADA). With extensive experience treating complex diabetic foot ulcers and lower-extremity wounds, our team is committed to delivering world-class care using the latest evidence-based techniques.
Take proactive steps toward healing today. Call our office to schedule a same-day appointment at (505)247-4164.
