Do you have a diabetic foot wound and aren’t sure how to take care of it? Do you have a wound that is taking longer to heal than expected? Have you heard or even seen firsthand how diabetic wounds can quickly get out of hand and lead to very serious complications? In this blog, we will explore the basics of diabetic wound care and the prevention of diabetic wounds.
Why People With Diabetes Develop Foot Wounds
First, let's discuss why people with diabetes are more likely to develop foot wounds than people without diabetes. When someone has diabetes, they have chronically elevated blood sugar levels. The increased sugars directly damage the nerves and lead to a condition called diabetic peripheral neuropathy which can make it difficult or even impossible to feel your feet.
If you can’t feel your feet very well, then you may not notice a blister or sore spot that could turn into an open wound. Many patients may not know they have a wound until they see blood in their socks because they cannot feel their feet. Increased pressure in areas of the feet can cause skin breakdown and lead to wounds.
Elevated blood sugar levels seen in diabetes also directly damage blood vessels and can cause decreased blood flow to the legs and feet. Good blood flow is essential to the wound healing process for many reasons. Diabetes also makes the skin more dry and less stretchy and elastic which increases the chances of developing cracks in the skin which can be a portal through which bacteria can enter the body and cause infections. Lastly, diabetes can decrease your immune system response and make you more likely to develop infections and make it harder for you to fight off an infection if you do develop one.
For all of these reasons, people with diabetes are more likely to develop foot wounds and have a harder time healing them than people without diabetes.
Preventing and Treating Diabetic Wounds
To prevent and heal diabetic wounds, we must address the previously discussed issues that cause these wounds in the first place. The best initial treatment for diabetic wounds is preventing them from occurring in the first place.
If someone has trouble feeling their feet due to diabetic neuropathy it is essential that they perform daily foot exams. The purpose of these exams is to examine the feet for blisters, cuts or wounds that they may not feel. It is also recommended to check your shoes for pebbles or other debris that might be hiding in the shoes.
Daily moisturizer application to the feet can help to prevent dry skin caused by diabetes that can lead to cracks and fissures in the skin. It is important to address areas of increased pressure on the bottoms of the feet which can lead to wounds. Your podiatrist will evaluate the shape of your feet to determine which areas have increased pressure which are areas where wounds are more likely to occur. Based on the shape of your foot, your podiatrist may recommend special shoes or insoles to offload pressure from these areas.
What To Do If You Develop a Diabetic Wound
If you do develop a diabetic wound, see your podiatrist right away for advice on how to take care of it. If left untreated, diabetic wounds can quickly worsen and lead to very serious complications such as amputation of toes, or even loss of your leg. Seeing your podiatrist as soon as possible when you develop a diabetic wound can help to prevent these negative outcomes.
Your podiatrist may debride the wound which involves removing nonviable tissue which stimulates wound healing. Your podiatrist may give you a special shoe or boot to offload pressure from the wound. Reducing pressure on the wound is essential to ensure healing. Frequent dressing changes are essential to diabetic wound healing. Depending on the nature of the wound, your podiatrist will recommend a specific type of dressing, bandage and/or ointment.
Some wounds are too wet and some are too dry so your podiatrist will determine the best combination of bandages and medication that works for your wound. Your podiatrist may discuss using a graft on your wound if indicated. A graft is a special substance that covers your wound and stimulates wound healing.
Wounds cannot heal if they are infected so your podiatrist will evaluate your wound for signs of infection and address those with antibiotics if necessary. Good blood flow is essential for wound healing so your podiatrist will evaluate your blood flow when you visit. If poor blood flow is suspected then your podiatrist may order additional tests and/or refer you to a vascular doctor if necessary.
It is very difficult for wounds to heal if your diabetes is not well controlled. Please see your primary care doctor or endocrinologist for medical management of diabetes to ensure proper blood sugar control. Proper nutrition is helpful for speedy wound healing as well as for general diabetic management. Consider seeing a Nutritionist for advice on how diet can affect blood sugar levels as well as wound healing potential.
When to See a Podiatrist
Whether you are worried about developing a diabetic wound or already have a wound and need help caring for it you should see your podiatrist right way. Podiatrists are uniquely trained in both the treatment and prevention of diabetic wounds. Healing diabetic wounds can sometimes be a slow process but with the care of your podiatrist most wounds can be healed in a timely fashion.
