Diabetic Ulcers

 

Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. The risk of lower extremity amputation is 15 to 46 times higher in diabetics than in persons who do not have diabetes.

 

Podiatrists have an important role in the prevention or early diagnosis of diabetic foot complications. Management of the diabetic foot requires a thorough knowledge of the major risk factors for amputation, frequent routine evaluation and meticulous preventive maintenance.

 

Common risk factors for ulcer formation include;

 

• diabetic neuropathy,
• structural foot deformity
• peripheral vascular disease
• corns and calluses resulting in focal areas of high pressure
• dry, fissured skin eg heel cracks
• Limited joint mobility
• Obesity
• Impaired vision
• Poor glucose control leading to slower wound healing
• Poor supportive or ill fitting footwear that causes skin breakdown, or areas of friction
• History of foot ulcer or lower extremity amputation

 

How can we help you?

A thorough assessment of the circulation of your foot (includes doppler assessment of the circulation of your big toe and main arteries in relation to your normal arm pressure)

• Treatment of any ulcers, wounds, infections that may develop as the result of poor circulation, injury or skin breakdown. (this includes debridement of excess callus that builds up around the ulcer thus slowing healing, pressure area care using padding with apertures to relieve pressure from the ulcer site, orthotic devices to reduce biomechanical forces that may be contributing to excess pressure on the area.)
• Review of Footwear is essential to ensure that are well fitted and not causing pressure areas at ulcer sites or creating potential pressure areas.
• Neuropathy detection tests; (1/- using 5.07 monofilament, 2/- vibration, 3/- reflex tests)

Prevention is the best possible solution, and this is where David Webby Podiatry is proactive in teaching patients how best to look after their feet, awareness of the possible foot complications of Diabetes, thorough assessments, and communication with their GP's to aid a multidisciplinary approach for foot care.

David also provides routine care where needed to reduce the likelihood of patient foot complications. Such treatment includes;

• Care of toenails, and proper instruction on how to cut toenails so ingrown toenails can be best avoided.
• Treatment of corns, calluses If they are allowed to progress the skin may break down and sores may develop beneath them and prove difficult to heal.
• Treatment of other foot pain and review of biomechanics ie the way people walk, that may be contributing to abnormal friction or pressure areas. (See latest news for introduction of the new 'Vasyli-Armstrong Diabetic Orthotic)
• Review of current footwear to see if ill fitting or support.
• Footcare advice regarding the risks and complications that your foot could develop..

 

Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation.

 

 

 

(See Foot Care for daily tips for good foot health)

 

 

To make an appointment for any of the above conditions, please call us... or send an enquiry e-mail

To read more about various foot conditions, please click here