Treatment Options For Foot Ulcers
A DFW wound care doctor can examine your feet, check for signs of infection, and recommend treatment options for your diabetic foot ulcer based on your specific condition and needs. For foot ulcers that are severely infected or spreading to other areas, hospitalization may be needed.
According to our DFW wound care doctor, some of the most common treatments for a foot ulcer are:
- Off-loading.Off-loading is recommended to take pressure off the ulcer. This can be done by using padding over the ulcer, crutches while walking, a brace or cast on the foot, or a compression wrap.
- Medication. If there are signs of an infection, an antibiotic ointment can be put on the ulcer then covered with a dressing or bandage. An oral antibiotic may also be prescribed to help with infection.
- Cleaning. The ulcer should be kept clean and dry. This can be done by washing the ulcer daily with a mild soap and warm water and changing any dressings or bandages used to cover the ulcer.
- Debridement. Removing any dead skin or tissue by debridement is often done to speed up the healing process. Debridement is done by a podiatrist using a sharp tool to remove the skin and tissue.
- Surgery. If more conservative foot ulcer treatments have not been successful, surgery may be recommended. Surgery can be done to correct a foot deformity such as a hammertoe or bunion that is causing the foot ulcer. Also, shaving or removing bones is an alternative option.
What To Do When Foot Wounds Wont Heal
Foot wounds, or ulcers, occur when the outer layers of the skin are damaged, thus exposing the deeper tissues of the feet. Ulcers can form due to wearing shoes that dont fit correctly or from an injury that breaks the skin. Ulcers are most common in patients who have diabetes, neuropathy or vascular disease, and these open wounds can become infected if left untreated. While the wounds may not be painful, common signs include redness, inflammation, an odor, or thickened tissue. Patients who are at a higher risk for foot wounds, or have wounds that dont heal, should consult with a podiatrist. Usually, a podiatrist will remove the unhealthy skin to assist with healing. Then, depending on the situation, special shoe padding, antibiotics, or surgery may be recommended for treating the wound.
Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Serjik Nazarian, DPM from Sedona Foot & Ankle Specialists. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Wound Care?
Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic.
Contact Dermatitis And Poison Ivy
Sores on the bottom of feet can also be due to contact dermatitis. It can be due to an allergic reaction or irritation to several irritants. There are several allergens and irritations that can be blamed. These can include chemicals and dyes used to manufacture shoes and socks, soaps and detergents, etc.
Blisters can also form in reaction to poison ivy if the bottom of the foot is exposed the best treatment so far will involve lotions or creams containing calamine as well as oral or topical antihistamines.
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Take Pressure Off The Area
If a wound continues to reopen or experience damage, it wont heal quickly and may get much worse. So avoid putting stress, pressure and weight on wounds.
This can be tricky for some wounds like ones on your feet. If you need help, talk to your doctor about ways to protect your wounds while maintaining mobility. Special shoes and customized foot padding are common options.
Diabetes And Cuts On Feet
Having diabetes can further complication the length of time for a cut to heal, and also increase the risk of infection and further complications.
Diabetes is a complex process and can slow the rate of healing. Diabetics are at increased risk of infections, amputations and death.
Some diabetics may have numbness in the feet , which further complicates treatment.
Diabetics are also at increased risk of reduced blood supply to the toes, without good blood supply cuts can deteriorate rapidly and its common to see diabetics requiring amputations.
If you are diabetic, and have obtained a cut or wound on your foot. Follow the steps for self care, and make an appointment with your health professional for further assessment.
Even if you dont have an infection, I still highly recommend you see your local professional as the risks are very high for diabetics, especially if your a long term diabetic or have unstable blood glucose levels.
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What Is A Diabetic Foot Ulcer
A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.
Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable.
Common Causes Of Foot Wounds
Many slow-healing foot wounds start with small injuries that break the skin on your feet or toes. Maybe you stepped on something while walking barefoot, or maybe you developed blisters from a new pair of shoes. Once the skin is broken, youre at risk of infection and other wound complications.
Friction can also cause foot wounds to develop. Your skin breaks down over time if it rubs repeatedly against socks or shoes. You may be more likely to develop a wound from friction if you have another foot condition, like bunions, corns, or hammertoe.
Small injuries might go unnoticed at first. But if they dont heal properly, they can continue getting worse. Your risk of suffering a slow healing wound goes up if you have certain health conditions, including:
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What Are Neurotrophic Ulcers
Neurotrophic ulcers occur primarily in people with diabetes, although they can affect anyone who has impaired sensation in their feet. They can be found anywhere on your feet, but they usually develop on the parts of your feet and toes that are most sensitive to weight .
Neurotrophic ulcers dont cause pain. But they can be serious if they arent treated promptly or they dont respond to treatment.
A neurotrophic ulcer might be the following colors:
- Any combination of those colors.
The thin borders of the ulcers are punched out, meaning that theyre taller than the surrounding tissues.
Signs & Symptoms Of A Foot Ulcer
A foot ulcer can be shallow or deep. When it starts, it looks like a red crater or dimple on the skin. If it becomes infected, it can develop drainage, pus, or a bad odor.
If you have nerve damage in your feet, then you won’t notice the pain of a small stone, too tight shoes, or the formation of a foot ulcer. As you get older or have a medical condition like diabetes or Raynaud’s phenomenon, it’s best to check your feet regularly for damage and sore spots and consult your doctor.
Venous ulcers – Patients with vein ulcers may complain of swollen, tired, and achy legs. Venous ulcers are not typically very painful unless touched, or unless they are infected.
Arterial ulcers – Patients with arterial disease may complain of tingling, burning, or coldness in the feet or toes. Patients may also experience leg pain when walking, or foot pain when elevating the legs. Ulcers usually occur at the tips of toes or on the sides of the ankles or lower calves. The ulcer may look punched out with a yellow-brown or black color. They are often very painful unless there is nerve damage.
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Healing A Cut In The Crease Of Toes
OUCH! These hurt! If this has happend to you by a forign object treat as mentioned in the above post.
However, if the cut has come out of nowhere or you dont remember injuring yourself, it is possible you could have a fungal infection.
The feet generally sweat and moisture can build up between the toes.
I have seen some very manky toes in my time, some of them caused by too much moisture around the toes, feeding the fungus that lives naturally on our bodies.
If you think you have a fungal infection, try an antifungal cream or spray and follow the directions on the label.
It is always best to get a medical health professional to assess first to ensure this is the right treatment for you.
Having an open cut, as mentioned earlier, can expose your body to bacteria on our skin and within our environment, so always best to play on the side of caution and treat the cut to prevent any complications.
How Are Foot And Toe Ulcers Diagnosed
Your healthcare provider can tell what type of ulcer you have based on four observations:
- The appearance of the ulcer.
- Location of the ulcer.
- The appearance of the borders.
- The appearance of the surrounding skin.
Your primary healthcare provider can diagnose an ulcer, but they might send you to a specialist for treatment. You might see a podiatrist, a provider who works with feet, or a wound specialist. For more complicated cases that require surgery, you might also see a plastic surgeon, anesthesiologist, orthopedic surgeon and/or vascular surgeon.
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Essential Tips For Foot Wound Care
No matter how careful you try to be as you go through life, minor cuts, scrapes, bruises and sometimes even more serious wounds do happen. When the injury occurs on your feet, heels or ankles, it can be especially painful and hard to heal. Thats why proper care and treatment for a foot wound from the very moment it occurs is very important to ensure proper healing.
As a podiatrist with Westchester Health, Ive noticed over the years that many people lack a good working knowledge of how to care for wounds that need immediate attention but are not serious enough to warrant a trip to the emergency room. To help rectify that, Ive put together some guidelines that explain what to do in case you do sustain an injury to the foot, ankle or lower leg.
What Are Foot Ulcers
A foot ulcer is an open sore on the foot.
A foot ulcer can be a shallow red crater that involves only the surface skin. A foot ulcer also can be very deep. A deep foot ulcer may be a crater that extends through the full thickness of the skin. It may involve tendons, bones and other deep structures.
People with diabetes and people with poor circulation are more likely to develop foot ulcers. It can be difficult to heal a foot ulcer. In people with these conditions, even a small foot ulcer can become infected if it does not heal quickly.
If an infection occurs in an ulcer and is not treated right away, it can develop into:
- A spreading infection of the skin and underlying fat
- A bone infection
- Gangrene. Gangrene is an area of dead, darkened body tissue caused by poor blood flow.
Among people with diabetes, most severe foot infections that ultimately require some part of the toe, foot or lower leg to be amputated start as a foot ulcer.
Foot ulcers are especially common in people who have one or more of the following health problems:
- Peripheral neuropathy. This is nerve damage in the feet or lower legs. Diabetes is the most common cause of peripheral neuropathy. When nerves in the feet are damaged, they can no longer warn about pain or discomfort. When this happens, tight-fitting shoes can trigger a foot ulcer by rubbing on a part of the foot that has become numb.
In addition to diabetes, other medical conditions that increase the risk of foot ulcers include:
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How Should A Diabetic Foot Ulcer Be Treated
The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing of the wound, the less chance for an infection.
There are several key factors in the appropriate treatment of a diabetic foot ulcer:
- Prevention of infection
- Taking the pressure off the area, called off-loading
- Removing dead skin and tissue, called debridement
- Applying medication or dressings to the ulcer
- Managing blood glucose and other health problems
Not all ulcers are infected however, if your podiatric physician diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
Preventing Infection
There are several important factors to keep an ulcer from becoming infected:
- Keep blood glucose levels under tight control
- Keep the ulcer clean and bandaged
- Cleanse the wound daily, using a wound dressing or bandage
- Do not walk barefoot
Off-Loading
For optimum healing, ulcers, especially those on the bottom of the foot, must be off-loaded. Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches. These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.
Applying Medication and Dressings
For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist may order evaluation test such as noninvasive studies and or consult a vascular surgeon.
Managing Blood Glucose
Keep Your Wound Clean And Covered With The Right Dressings
Wounds heal best when they are clean and moist. So its important to get them clean and covered right away. If you have a new scrape or cut, a basic bandage and antibiotic cream should work just fine.
But if you have wounds that are infected, slow healing or more serious, make an appointment with a doctor to learn what the best wound care is for you. Your doctor will likely recommend different types of diabetic wound care dressings to protect the injury and promote healing.
Common types of dressings for diabetic wound care
- Foam dressings Extremely soft and absorbent, foam dressings are used for wounds that leak or ooze a lot. They also offer added cushioning which can help protect the wound against physical damage.
- Alginate dressing These types of dressings are primarily made from seaweed. They can hold up to twenty times their weight in moisture, making them a great choice for deep wounds and ones with discharge. Another advantage of alginate dressings is that they prevent the growth of new bacteria.
- Hydrogel dressings Hydrogel is a water-based gel designed to keep an area moist. If your wound is dry or covered in dead skin, your doctor may recommend a hydrogel dressing to provide moisture. This can help break down dead tissue and promote cell growth. These types of dressings usually arent used for infected wounds.
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Prolonged Pressure On The Feet
As mentioned in the previous example, when shoes fit poorly, ulcers can occur. In people without nerve damage, this is usually due to severe atherosclerosis, or a deformity such as a fracture. Elderly patients often have difficulty or find it uncomfortable to examine their feet, ignoring moderate pain from pressure on the feet, which may result in the development of an ulcer.v
What To Do When You Cut Your Foot
For minor cuts:
- Apply direct pressure to stop any bleeding
- Wash your hands
- Clean the cut use antiseptic such as iodine and ensure there is no debris in the wound
- cover the cut with dressing
- Protect the dressing from being soiled or getting wet
- Change dressing as required
- Keep an eye on signs and symptoms of infection
- Try and rest the area
For more severe cuts:
- Apply direct pressure to the area- if you cant stop the bleeding and it is bleeding a lot call for an ambulance or get to your nearest ED
- Assess to see if you require stitches- if you do attend the Emergency Department or your local doctor
- If it appears superficial, follow the steps below and follow up with your local health professional if required
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Who Gets Foot And Toe Ulcers
Foot and toe ulcers can happen to many people but might be more common in Black, Native American and Hispanic people. If you have an eye, kidney or heart disease related to diabetes, youre also at a higher risk. About 15% of people with diabetes will get an ulcer, typically on the bottom of their foot. Some of those people will be hospitalized because of complications.
Youre also at a higher risk of getting foot and toe ulcers if you have any of the following conditions:
- Blood circulation issues.
If your ulcer is black, that means cells in the tissues have died. This is called necrosis .
Tips For Proper Wound Care
There are a few things that can help care for a foot wound as well as encourage proper and quick recovery times. Below, you will find some tips to assist you in proper wound care for future foot and ankle injuries. If you are not sure how to care for a specific foot wound, !
- Blood Isnt Bad
- When you cut your foot or step on a foreign object, it is good for it to bleed a little to help extract the object and clean the wound.
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