Diabetic foot ulcers are the most common cause for lower leg amputation, according to the American Academy of Family Physicians. A foot ulcer is diagnosed as any break in the top layer, or epidermis, of the skin. Diabetes patients suffer from decreased circulation and sensation in the feet; because of this, a diabetic is often unaware that an ulcer is forming. Simple open wounds such as a callus or open cut may rapidly deteriorate and turn into a larger ulcer if not treated. Improperly fitting shoes, incorrect weight bearing or infections may cause trauma leading to the formation of a foot ulcer, advises Columbia University Medical Center. Treating a foot ulcer is imperative to avoid complications.
Debridement
Debridement is a surgical procedure that involves removing infected and necrotic, or dead, tissue. All tissue is removed until a healthy, bleeding edge is exposed, reports the American Academy of Family Physicians. Removal of the tissue stimulates the foot ulcer to contract and heal. Healing does not occur immediately and multiple debridements may need to be performed to increase healing time, suggests Columbia University Medical Center. The procedure can generally be done at a clinical visit or in an operating room, and patients often return home the same day. Local anesthesia is often prescribed to decrease pain from the procedure. However, more extensive debridement is sometimes required for extremely infected foot ulcers.
Close Monitoring
The wound must be closely monitored during the healing process to determine whether care is effective. Measurement of the wound as well as photography are standard protocol in most medical communities. Some centers may use digital photography and computer programs to create graphs to measure wound healing. If an ulcer begins to tunnel into the skin, the depth of the foot ulcers is also measured. The color of drainage, surrounding tissue and other observations should be recorded when a dressing change occurs.
Wound Care and Dressings
Topical dressings are applied to diabetic foot ulcers to decreased infection and promote healing. Columbia University Medical Center states there is controversy about the best type of dressing care for a diabetic ulcer, and standards of care have not yet been developed. The medical center suggests a moist setting is a priority for wound healing; dry skin tissue will cause infection and will become necrotic causing the wound to deepen. How often a dressing is changed is highly individualized. Timing depends on wound location, depth, presence of infection and other factors. A diabetic foot ulcer is constantly changing and should be reevaluated on a consistent basis.
