Diabetes mellitus is a serious metabolic disease resulting from the body's inability to produce enough insulin, leading to high levels of glucose in the bloodstream. A diabetic foot ulcer is an open wound that does not heal properly. It forms as a result of poor circulation and peripheral neuropathy, a lack of feeling in the extremities. Diabetic foot ulcers are a common complication of diabetes and can lead to foot or limb amputation if not treated properly. A diabetic foot ulcer should always be treated by a medical professional.
Relieve Pressure
For diabetics, pressure is the enemy. Diabetic foot ulcers form in response to excessive pressure on the skin. It is important to purchase shoe gear that fits properly and does not pinch the toes. Once an ulcer does form, it may be best to purchase special custom-made shoes that fit to the form of the foot. If an ulcer forms on the heel, there are special cushioned booties available that strap on and are worn to bed to protect the heels. For severe ulcers, it may be necessary to use crutches, a wheelchair or a total contact cast to allow the foot to be completely non-weightbearing in order to promote healing.
Debridement
To keep the ulcer clean and free from infection, it should be washed or soaked every day. Any dead skin or exudate needs to be scraped away by a process called debridement. According to ClinicalDiabetes, debridement exposes the healthy tissue below the ulcer, promoting healing. Debridement is usually done during an office or clinic visit, but if the ulcer is deep enough, it may have to be performed in an operating room.
Wound Dressings and Antibiotics
It is very important to keep a diabetic foot ulcer clean and free from infection. Wound dressings, often employed along with antibiotic treatment, act to protect the ulcer from the environment. Wound dressings can consist of an absorbent gauze, such as Curasorb, along with a sterile wrapping gauze and medical tape. Systemic antibiotics, such as Augmentin, as well as a topical antibiotic, like Neosporin or Silvadene cream, can be used along with a dressing to treat the ulcer if it is infected.
Hyperbaric Oxygen
Hyperbaric oxygen therapy can be used to treat ulcers that prove difficult to heal. It features a specialized chamber, called a pressure chamber. According to MedlinePlus, the air pressure inside the chamber is approximately two and a half times greater than normal atmospheric pressure, which helps the blood to carry more oxygen to the affected tissues, promoting healing.
Skin Grafts and Vascular Surgery
If a diabetic foot ulcer does not respond to any of the other treatments, it may be necessary to use a skin graft to close the ulcer. There are two types of grafts available, human skin grafts and bioengineered skin grafts. If the underlying circulation is extremely poor, then a bypass or distal arterial reconstruction may be required to restore blood flow to the foot.
