Diabetic Foot Ulcers: Causes, Prevention, and Treatment
Diabetic foot ulcers are a major complication of diabetes that can lead to serious consequences if l...
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Diabetic foot ulcers are a major complication of diabetes that can lead to serious consequences if left untreated.
These open sores or wounds typically form on the bottom of the feet and are caused by nerve damage (neuropathy) and poor circulation associated with diabetes. Without feeling in their feet, diabetics can suffer cuts, blisters, or burns that go unnoticed. These minor injuries then worsen over time into painful ulcers.
About 15% of people with diabetes will develop a foot ulcer in their lifetime. The statistics are even more alarming when you consider that a staggering 85% of all diabetes-related lower-limb amputations are preceded by a foot ulcer.
This demonstrates how critical it is for diabetics to understand foot ulcer causes, implement preventive strategies, and seek immediate treatment if they develop an ulcer.
Causes and Risk Factors
There are a number of factors that contribute to the formation of diabetic foot ulcers:
● Peripheral Neuropathy - This nerve damage in the feet causes numbness, tingling, and lack of feeling. With this loss of protective sensation, people cannot feel irritations and injuries to their feet. Even small cuts or blisters can go unnoticed and worsen. Neuropathy is present in over 50% of diabetic foot ulcers.
● Peripheral Arterial Disease (PAD) - PAD causes the narrowing of blood vessels, reducing circulation to the extremities. Poor blood flow impairs wound healing and increases the risk of infections spreading. PAD contributes to over 60% of diabetic foot ulcers.
● Abnormal foot structure - Foot deformities like bunions, hammertoes, and bone spurs lead to increased friction and pressure on the foot. This added pressure can cause skin breakdown and ulcer formation, especially in those with neuropathy.
● Prior history of ulcers or amputation - Once someone has a foot ulcer or amputation, they are very prone to additional recurrences of ulcers due to the existing neuropathy and PAD.
● Poorly controlled blood sugar - High blood glucose causes nerve damage and impairs immunity and circulation. This greatly increases susceptibility to ulcers forming and having complications.
Prevention Strategies
There are several important prevention strategies that can reduce the likelihood of developing foot ulcers:
● Daily foot inspections - Check both feet daily for any cuts, blisters, red spots, swelling, or signs of abnormal pressure.
● Maintain target blood sugar levels - Work closely with your healthcare provider to keep blood sugar tightly controlled.
● Wear proper footwear - Shoes should have a wide toe box and fit well. Avoid going barefoot and wear diabetic socks.
● Regular podiatrist visits - Have nails trimmed, calluses removed, and a professional foot exam.
● Improve circulation - Simple exercises like walking help circulation. Avoid smoking.
Treatment Options
If an ulcer does develop, the following treatment options are available:
Offloading pressure
Devices like total contact casts, special boots, and crutches are used to redistribute pressure away from the diabetic foot ulcer in order to offload the wound and prevent further mechanical damage that would impair healing.
Debridement
The removal of damaged, infected, or necrotic tissue through debridement speeds the healing of diabetic foot ulcers by cleansing the wound and stimulating new healthy granulation tissue and growth factors.
Moist wound care
Saline soaks and moisture-retentive dressings create an optimal moist environment that promotes the healing of diabetic foot ulcers by facilitating new tissue growth, cell migration, and removal of dead tissue.
Medications
Antibiotics treat infections, while growth factors and skin substitutes encourage healing. The use of Dermlin products can significantly shorten the wound healing time, and no allergies or other adverse reactions were found.
Advanced therapies
Negative pressure wound therapy, hyperbaric oxygen therapy, and skin grafts are advanced treatment options for severe or non-healing diabetic foot ulcers that can help stimulate healing in cases where first-line treatments have failed.
Surgery
Surgery may be necessary to remove infected or necrotic tissue or improve blood flow to the diabetic foot ulcer area, promoting healing of the wound.
Prompt treatment aligned with the wound stage gives the best chance for healing and preventing amputation. Patients should see a podiatrist or wound care specialist immediately if they develop an ulcer. With comprehensive treatment, most foot ulcers can be healed.
Final Thoughts
To wrap up, foot ulcers are a common and serious problem for people with diabetes that should not be ignored. Because of nerve damage and poor blood flow, even small cuts or blisters on the feet can turn into big, non-healing wounds.
It's crucial to take preventive steps - check your feet every day, wear shoes that fit right, keep blood sugar under control and see a foot doctor on a regular basis.
If a sore does show up on your foot, get medical care right away from a foot doctor or wound care expert. Follow the treatment plan closely to give the ulcer the best chance of healing.
Advanced treatments like removing damaged tissue, keeping the wound moist, using special boots or devices, applying skin substitutes, and surgery can help close up stubborn foot ulcers.
While foot ulcers can be hard to take care of, most can be healed with commitment and proper medical care. Stay on top of prevention and get early treatment if a wound starts. Working with your healthcare providers and doing what they say meticulously offers hope.
With diligence and quick care, the devastating effects of diabetic foot sores can often be prevented.
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