People with diabetes are more susceptible to foot problems for two major reasons: neuropathy (nerve damage) and poor blood circulation, according to the American College of Foot and Ankle Surgeons. Neuropathy can be dangerous because a loss of feeling in the foot can occur, causing the person to lose the pain sensations and other warnings that can signal problems. In addition, poor circulation in the foot not only reduces blood flow, but also the body's ability to heal, which can lead to foot ulcers and infections. Treatments for foot ulcers in diabetics include several approaches; proactive measures may ensure the ulcers don't become severe, leading to amputation.
Offloading and Protective Footwear
An ulcer is a sore that may penetrate to the bone, according to the American College of Foot and Ankle Surgeons. When an ulcer forms on the foot, self-care measures are vital to helping the sore heal. Staying off the affected foot is an effective treatment called "offloading." Patients can use a wheelchair or crutches to eliminate weight bearing. Another effective offloading method is to wear a total contact cast (TCC). While these casts are complex and time-consuming to apply, they have been shown to greatly reduce pressure on ulcers and heal between 73 and 100 percent of wounds treated with them, according to the American Diabetes Association (ADA). Postoperative and wedge shoes may also help, but should be large enough to contain bulky dressings.
Debridement and Dressings
For people with a foot wound, treatment may consist of debridement. Debridement includes removal of all necrotic (dead) tissue, peri-wound callus and foreign bodies, down to viable tissue. According to and article in "ClinicalDiabetes," by Ingrid Kruse, DPM and Steven Edelman, M.D., proper debridement is required to reduce the risk of infection and peri-wound pressure, which can hinder normal wound contraction and healing. After the wound is treated, it is cleansed with a saline solution and then covered with a dressing, to keep it clean and protected. A proper dressing will function as a barrier, protecting the wound from contamination and preventing dessication (drying out). A wide variety of dressings are used, including absorbent polymers, foams and hydrogels.
Antibiotics
Antibiotics are useful for helping to heal foot ulcers and other infections in the body by killing bacteria and keeping them from reproducing. Take the full course prescribed, even if you notice improvements. Discuss side effects with your doctor. Generally, inflamed bowels, resulting in diarrhea, occurs in the elderly with the use of antibiotics.
