Foot ulcers are a challenging complication of diabetes. These open wounds on the feet and toes form as a result of skin tissue breaking down and exposing the layers underneath. While foot ulcers can affect all people with diabetes, good foot care can help prevent them.
To help you make informed decisions, our expert podiatrists put together this guide on understanding diabetic foot ulcers.
Diabetic Foot Ulcer Causes
Approximately 15% of people with diabetes develop foot ulcers.
This is most commonly due to:
- high blood sugar, which can affect the body’s ability to heal wounds.
- poor circulation in which blood doesn’t effectively flow to the feet.
- nerve damage, leading to a loss of feeling in the feet that can result in painless wounds.
- irritated or wounded feet.
Diabetic Foot Ulcer Symptoms
Common early symptoms of diabetic foot ulcers are:
- drainage from your foot,
- irritation,
- odors,
- redness,
- and unusual swelling.
One indicator of a severe foot ulcer is the presence of eschar that surrounds the ulcer. Eschar is dead tissue cast off from the skin. It is dark in color, typically black, and may be crusty.
Partial or complete gangrene is another symptom. Gangrene is the death of body tissue due to a lack of blood flow or a serious bacterial infection. As a result, foul-smelling discharge, pain, and numbness can occur.
Diabetic Foot Ulcer Diagnosis
Talk with your doctor if you feel any pain around a calloused or irritated area or see any skin discoloration, especially black tissue. To identify the seriousness of the ulcer, they’ll likely use the Wagner Ulcer Classification System.
This grading scale assesses the ulcer depth and presence of gangrene.
- Grade 0: The skin is intact. There could be a healed or pre-ulcerative wound.
- Grade 1: There’s a superficial ulcer without penetrating to deeper layers.
- Grade 2: It’s a deeper ulcer that reaches the tendon, bone, or joint capsule.
- Grade 3: Deeper tissues are involved, and there is abscess formation, osteomyelitis, or tendonitis.
- Grade 4: Gangrene is in a portion of the forefoot or heel.
- Grade 5: Gangrene is extensive, involving the entire foot.
Treating Diabetic Foot Ulcers
Foot ulcers may take weeks or several months to heal. Since walking can make the ulcer expand, stay off your feet as much as possible.
Nonsurgical treatments include:
- antibiotics,
- antiplatelet or anticlotting medications,
- compression clothes or wraps,
- orthotics,
- removing pressure from the area by wearing a cast, foot brace, or specific shoe (nonsurgical off-loading),
- and topical wound care.
Debridement is a procedure doctors use to remove dead or infected skin tissue and remove foreign materials. This can help encourage healing and reduce the complications of infections.
Doctors may also send a tissue sample to a lab to determine which antibiotics will help. If a serious infection is suspected, an x-ray or MRI may be utilized to look for signs of bone infection.
Surgery won’t likely be necessary to heal your ulcer. However, if other treatment options aren’t effective, surgery can prevent your ulcer from becoming worse. Infected ulcers can result in amputation if neglected.
To keep an ulcer from becoming infected, be sure to:
- avoid going barefoot.
- cleanse the wound daily with mild soap.
- keep blood sugar levels under control.
- keep the ulcer clean and bandaged.
Embryonic Tissue Grafts
Embryonic tissue grafts, specifically the use of the human amniotic membrane (HAM), are a new treatment for diabetic foot ulcers. HAM is a reproductive tissue representing the innermost layer of the human placenta. It contains amino acids, nutrients, cytokines, and growth factors that can contribute to wound healing.
Grafts applied to the ulcerated area to stimulate tissue regeneration and promote wound closure in foot ulcers might decrease the chance of amputation.
Preventing Diabetic Foot Ulcers
Taking care of your feet regularly will lower your chances of having diabetes-related foot problems.
Here are guidelines to follow.
- Wash your feet daily and moisturize.
- Inspect your feet daily for skin or nail problems.
- Have a podiatrist trim calluses or corns.
- Trim your toenails properly.
- Always put on a pair of shoes or slippers.
- Wear comfortable, well-fitting shoes.
- See a foot doctor regularly.
See A Podiatrist
If you’re experiencing pain in your foot or ankle, visit The Foot & Ankle Center! Since 1989, we have been proud to deliver the highest quality of care to patients in a comfortable and convenient setting.
Our board certified podiatrists have the ability to pinpoint the source of your pain and recommend treatment. To get started, request an appointment online or give us a call at (314) 487-9300!