(Diabetic) foot wounds or ulcers are open sores typically formed on legs of diabetic patients. Ulcers are formed when the skin breaks up and the underlying tissues are exposed. According to APMA, American Podiatric Medical Association, around 15% of diabetic patients develop foot ulcers and among them, up to 25% may need an amputation. However, those who have had an amputation are at risk of losing their lives in less than 5 years as it becomes difficult for the amputation wound to heal.
What causes diabetic foot ulcers?
- Poor blood circulation (Lower Extremity Ischemia) . One form of vascular disease wherein the blood doesn’t circulate properly to the legs resulting in formation of wounds/ulcers and also makes it difficult to heal.
- Hyperglycemia / High blood sugar levels. High sugar levels in blood make it difficult for the body to fight off infections. Even a small prick may become a large wound that is difficult to treat.
- Peripheral Neuropathy (loss of sensation due to nerve damage). This condition is the cause of foot ulcers in 90% of the cases. If the nerves in the feet are damaged (high blood sugar levels in blood have a negative effect on nerves, veins and arteries in the body), it becomes difficult for a person to feel any injury to the legs (or in the infected area)
Symptoms of Diabetic Foot Ulcers
The most common symptom of diabetic foot ulcers is the darkening of the skin on the area, initially to bluish or dark brown and then to black as the skin dies due to insufficient blood supply. Then, there may be pus oozing out of the wound/ulcer along with pain, swelling, inflammation, and irritation.
The next stage will be the death of the underlying tissue due to infections (called gangrene). This may be accompanied by smelly discharge, and pain and the area may also become numb.
You should see your general physician or a diabetic wound care specialist as soon as you see any of these symptoms. If you see any change in colour of skin associated with pain near your feet and if you know that you are diabetic, you must see your doctor and get it checked up. Remember, a stitch in time saves nine and who knows, that visit might save your limb and your life too. Your doctor will then assess the situation depending on the severity of the wound ranging from a simple lesion on the skin to a deep, damaged tissue underneath the skin and start treatment accordingly.
Painless treatment of diabetic wounds/ulcers
Usually, your general physician will be able to take care of the wound if it is in the initial stages. If he/she thinks that the wound is progressing without responding to the drugs administered, you will be referred to a wound or ulcer care specialist. Treatment for diabetic wounds or ulcers includes:
- Wound offloading. The idea is to remove the weight that may be applied on the affected area and let it heal. If the wound is under the feet, you may be asked to use a wheelchair until the wound heals completely. Special footgear or support may be given to reduce the pressure on the wound.
- Debridement – This is the process of removal of dead skin and tissue from the area to stop the infection from progressing to other surrounding areas.
- Dressings that help the skin to heal. Skin substitutes and collagen-infused dressings may be used to wrap the wound/ulcer which can help the wound heal faster by supplying the basic building blocks for new skin. Some dressings may be designed to remove the moisture from the area and to prevent any further infection.
- HBOT (Hyperbaric Oxygen Therapy) – If treated at the right time (unless it’s too late), HBOT can help wounds heal without any medicines. Of course, your doctor might put you on medication that can help control infection, if any. Oxygen therapy supplies a lot of oxygen to the wound and also during the procedure/therapy, a lot of oxygen gets dissolved in blood plasma and gets supplied to every corner of the body. HBOT helps in regenerating blood vessels (angiogenesis) that will be able to supply blood to the wound. This not only helps fight off infection but also helps the wound heal faster. (75% faster). Research studies have shown that HBOT intervention can reduce the chances of amputation of limbs to a great extent
- Vascular wounds that may not be necessarily due to diabetes are also treated at our wound or ulcer care center in Chennai. Our expert doctors assess the condition of the veins and arteries in the area and can treat the wound by fixing the problematic vein(s) or arteries.