Pain On The Foot’s Outer Edge
The outer edge of your foot, the fifth metatarsal bone, is a commonly broken bone in the foot. Pain, swelling, and bruising along the outer foot edge after an injury are symptoms. If you think you may have broken a bone, see a doctor and have an X-ray.
To treat it:
- Rest, ice, and elevate your foot.
- Donât walk on it.
- Ask your doctor if surgery is necessary.
- A cast may be necessary in some circumstances.
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.
How Should You Treat A Stage 1 Pressure Ulcer
If you believe that you have a stage 1 pressure ulcer, you should remove all pressure from the area. Keep the area as dry and clean as possible to prevent bacterial infections. To speed up the healing process, you should eat adequate calories and have a diet high in minerals, proteins, and vitamins. Zinc, iron, vitamin A, and vitamin C will play the biggest role in the healing process. Drink water frequently to remain hydrated.
Inspect the stage 1 pressure ulcer at least twice a day. Usually, you can reverse a pressure ulcer in this stage in about two to three days as long as pressure is removed. If the pressure ulcer hasnt gone away after three days, you should call your physician.
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Skin Status And Presence Of Pressure Ulcers
The presence of a category 1 pressure ulcer is correlated with a two-to-threefold increase in a patients risk of developing a more severe pressure ulcer . The presence of scar tissue and the presence of dry, thin or oedematous skin also increase the pressure ulcer risk. Ageing has been found to increase the risk of pressure ulcers due to the thinning of the epidermis as part of the normal ageing process . Ageing also causes the skin to become dehydrated and lacking in sebum , connective tissue to lose its elasticity and strength, and blood vessels to become increasingly fragile . Furthermore, subcutaneous tissues become thinner with age, which reduces the already minimal padding over the calcaneus and reduces the heels capacity to absorb shock .
What Are The Complications Of Bedsores
Once a bedsore develops, it can take days, months, or even years to heal. It can also become infected, causing fever and chills. An infected bedsore can take a long time to clear up. As the infection spreads through your body, it can also cause mental confusion, a fast heartbeat, and generalized weakness.
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How Can I Reduce My Risk Of Foot And Toe Ulcers
There are several things you can do to help reduce your risk of getting foot and toe ulcers. Sometimes, adopting these habits can even stop them from coming back. Try to:
- Manage your diabetes. If you have diabetes you should wear appropriate footwear and never walk barefoot.
- Examine your legs as well as the tops and bottoms of your feet and the areas between your toes every day. Look for any blisters, cuts, cracks, scratches or other sores. Also check for redness, increased warmth, ingrown toenails, corns and calluses. Use a mirror to view your leg or foot if necessary. If its difficult to see, ask a family member to look at the area for you. See a healthcare provider immediately if you notice any problems.
- Talk to your healthcare provider about ways you can stop smoking.
- Manage your blood pressure.
- Control your cholesterol and triglyceride levels by changing your diet. Limit salt in your diet.
- Care for your toenails frequently. Cut your toenails after bathing, when they are soft. Cut toenails straight across and smooth with a nail file. Take care of ingrown toenails.
What Causes Pressure Sores
Pressure sores are caused by sitting or lying in one position for too long. Its important to know that a pressure sore can start quickly. In fact, a Stage 1 sore can occur if you stay in the same position for as little as 2 hours. This puts pressure on certain areas of your body. It reduces blood supply to the skin and the tissue under the skin. If you dont change position frequently, the blood supply will drop. A sore will develop.
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How Are Pressure Ulcers Treated And Prevented
If you have developed a pressure ulcer on your foot, heel, or ankle, do not massage the skin surrounding the sore this can further damage the skin and worsen the problem. The best thing to do is to see a doctor as soon as possible, especially if you are experiencing any of these symptoms of infection:
- Pus coming from the sore
- Foul odor emanating from the sore
- Unusual warmth and swelling of the skin surrounding the sore
Medical treatment usually involves antibiotics, and possibly debridement, a process by which dead or infected tissue is removed from the wound.
This page was last updated on October 2nd, 2015
Significance Of The Heel As A High
After the sacrum, the heel is frequently reported as the second most common site for the development of pressure ulcers, as well as the site where the most severe pressure ulcers tend to develop . Heel pressure ulcers can cause pain, reduce mobility and in severe cases result in amputation . Heel pressure ulcers can be challenging to heal. In a cohort of 140 patients with heel pressure ulcers categorised as category 2 or above recruited to a prospective cohort study in one large teaching hospital in the UK, only 42% were reported to have healed over the 18-month study period .
Anatomy of the heel
TIME OUT 2
Do the risk assessments used in your clinical area include risk factors for pressure ulcers? What do you need to consider in your risk assessment to identify patients who are at high risk of developing pressure ulcers on the heel?
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What Are Pressure Ulcers
Pressure ulcers are sores that occur when pressure cuts off the blood supply to the skin. Stress caused by the bodys weight and the impact of striking the ground place the ball of the foot, the big toe, and the heel at the greatest risk. Left untreated, an ulcer may allow infection to enter your body. If infection reaches the bloodstream or bone, your life or limb may be at risk. But with your doctors help, your health can be protected. Pressure ulcers can be controlled and even prevented.
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How Big Are Foot And Toe Ulcers
There are many different sizes of ulcers. They start as small as 1 centimeter wide and can grow to the size of your entire foot if left untreated.
The depth of the ulcer can change, too. Several different classification systems exist to define the depth of an ulcer. The Wagner Diabetic Foot Ulcer Grade Classification System, for example, has six grades:
- Grade 0: Your skin is intact .
- Grade 1: The ulcer is superficial, which means that the skin is broken but the wound is shallow .
- Grade 2: The ulcer is a deep wound.
- Grade 3: Part of the bone in your foot is visible.
- Grade 4: The forefront of your foot has gangrene .
- Grade 5: The entire foot has gangrene.
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Causes Of Pressure Ulcers
Pressure ulcers are caused by sustained pressure being placed on a particular part of the body.
This pressure interrupts the blood supply to the affected area of skin. Blood contains oxygen and other nutrients that are needed to help keep tissue healthy. Without a constant blood supply, tissue is damaged and will eventually die.
The lack of blood supply also means that the skin no longer receives infection-fighting white blood cells. Once an ulcer has developed, it can become infected by bacteria.
People with normal mobility do not develop pressure ulcers, as their body automatically makes hundreds of regular movements that prevent pressure building up on any part of their body.
For example, you may think that you are lying still when asleep, but you may shift position up to 20 times a night.
Pressure ulcers can be caused by:
- pressure from a hard surface such as a bed or wheelchair
- pressure that is placed on the skin through involuntary muscle movements such as muscle spasms
- moisture which can break down the outer layer of the skin
The time it takes for a pressure ulcer to form will depend on:
- the amount of pressure
- how vulnerable a person’s skin is to damage
Grade 3 or 4 pressure ulcers can develop quickly. For example, in susceptible people, a full-thickness pressure ulcer can sometimes develop in just 1 or 2 hours. However, in some cases, the damage will only become apparent a few days after the injury has occurred.
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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What Are The Symptoms Of Pressure Ulcers
Pressure sores on the feet and ankles begin as areas of red, inflamed skin. Over time, the inflammation gets worse, and a blister develops.
This blister eventually becomes an open sore, and if treatment has not been administered before this, it is now a very serious condition. Skin that is this badly compromised is susceptible to infection, which can affect the entire body.
Pressure ulcers are categorized according to their severity:
- Stage I: An area of skin that does not blanch that is, it does not turn white when pressure is applied to it with a finger or other object. Stage I pressure ulcers on the ankles and feet can be harder to detect in this manner in people with darker skin, although the affected skin may appear blue or purple, and there may be sufficient discomfort to motivate the affected person to see a doctor. Regardless of skin color, the skin will be tender to the touch, and may be slightly warmer than the surrounding skin.
- Stage II: The epidermis is severely damaged, and may even be gone. The affected area becomes a blister and then an open sore. Redness and inflammation are apparent on the skin surrounding this blister or sore.
- Stage III: Tissue loss becomes more apparent at this stage. Tendons and muscles are not exposed , but subcutaneous fat may be. The sore has now become a sunken hole this is known as a crater.
- Stage IV: At this stage the sore is much deeper, and there may be damage to muscles, tendons, and even bone.
Living With Pressure Sores
Living with pressure sores requires a plan to move and turn frequently. Good hygiene will always be required. Pressure sores should be kept covered with a bandage or dressing. Sometimes gauze is used. The gauze must be changed once a day. Newer materials include a see-through film and a hydrocolloid dressing. A hydrocolloid dressing is a bandage made of a gel. It molds to the pressure sore and promotes healing and skin growth. These dressings can stay on for several days at a time.
Dead tissue in the sore can interfere with healing and lead to infection. Dead tissue looks like a scab. To remove dead tissue, rinse the sore every time you change the bandage. Special dressings can help your body dissolve the dead tissue on its own. The dressing must be left in place for several days. Another way to remove dead tissue is to put wet gauze bandages on the sore. Allow them to dry. The dead tissue sticks to the gauze until it is removed. For severe pressure sores, dead tissue must be removed surgically by your doctor.
Removing dead tissue and cleaning the sore can hurt. Your doctor can suggest a pain medicine. Take it 30 to 60 minutes before changing the dressing.
Healthy eating helps sores heal. Make sure youre eating the proper number of calories and protein every day. Nutrients are important too, including vitamin C and zinc. Ask your doctor for advice on a healthy diet. Be sure to tell them if youve lost or gained weight recently.
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What Are The Risk Factors For Pressure Ulcers:
People with fragile skin are at additional risk, as are people whose nutrition is poor. Diabetes is also a significant risk factor for pressure sores on the feet.
One of the reasons pressure sores are so common among the disabled is that many such people have impaired sensation of pressure and touch due to spinal cord injuries. Because of this, they may not be alerted by pain or discomfort to the need to change position.
People who are bedridden for extended periods may lose a great deal of weight, which reduces the cushioning around their bones, making them more susceptible to pressure sores.
Why Is It Necessary To Seek Immediate Medical Treatment For Foot Ulcers
It is important to treat foot ulcers as soon as possible because the longer an ulcer remains open the greater the chance of developing an infection. Ulcers become infected when germs or bacteria enter the break in the skin and start to grow, and spread. In severe cases infection can spread into the leg. Signs that an ulcer is infected include redness, swelling, increased drainage, sudden elevations in blood sugar, fever, chills and fatigue. Pain may be lacking because of neuropathy.
Ulcer treatment begins with recognizing and eliminating the cause. Frequently the cause is harmful pressure or rubbing against the skin that goes unnoticed because of the broken skin alarm detectors. Pressure reduction or off-weighting are the terms commonly used to describe elimination of the harmful pressure. Pressure reduction may be as simple as switching shoes or it may be more involved and require orthotics, braces or casts. Antibiotics and possibly even surgery may be necessary for some ulcers. Antibiotics will not help ulcers that are not infected. Dressings and care for the wound or ulcer are also important. Some persons will be able to do their own wound care and dressing changes, whereas, other persons will need the help of nurses. The majority of foot ulcers will respond to pressure reduction and dressings.