Healing Diabetic Foot Ulcers

In my practice, I treat a lot of diabetic patients, and I see a lot of diabetic wounds. In this case, the wounds are called diabetic foot ulcers.

When evaluating diabetic foot ulcers, some of the things we look for as foot specialists are signs of infection, size of the wound, lab tests, blood sugar levels, shoes, and circulation of the feet and legs. All of these are important. Also, getting a good history from the patient is very important. We need to know how long the wound has been present, what medications have been given, and if any other treatments have been rendered yet.

As a podiatist, my main goal is to save my patients' feet. So this is a very important topic for me. We need the patient to help us do our job to heal the diabetic foot ulcer. Whether that means staying off of the foot or wearing a special boot, the doctor knows best when it comes to healing the foot ulcer. The longer the ulcer remains open, the higher incidence of infection (whether it be in the soft tissues or in the bone). And once it goes into the bone, that is when amputation occurs.

Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
626-442-1223
www.elmontefootdoctor.com

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Please feel free to email me if you have any questions or if you would like to schedule an appointment, or you can visit our website or call our office.
dr.michele.colon@gmail.com

Podiatrists Save Diabetic Feet...It's Just What We Do

I had an experience yesterday that almost moved me to tears. In December I wrote about a gentleman who was incredibly close to losing his leg, if not his life (Here's the original post). Within a short time frame of days, he went from having a "minor" ulcer treated to a major infection of the foot which ended up with him losing two toes, but has retained the functional foot. Before the first operation, I had a conversation with the infectious disease physician caring for him who was insistent that my surgery was futile and he needed an amputation above his knee to save him. The patient and I discussed this and agreed that we wanted to try anyway.

During the first operation, I experienced an infected foot like I'd never seen before, even in my training. It was very apparent that the surgery didn't get rid of the infection like it should have. A few days later, another surgery with a toe amputated. The following week a third surgery with a second toe amputated. Then the miracle...

His fever dropped to normal, all the color came back into his face, his appetite returned. He looked healthy. He made a commitment to his wife, me, and most importantly, himself, to take this horrible time in the hospital and take charge of his diabetes. He did everything right to lower his blood sugar to normal levels. We sent him for Hyberbaric oxygen treatments which helped the residual minor infection to resolve and started to promote healing. As he was discharged, we put a negative pressure "VAC" dressing on his foot to further promote healing.

Our initial hope was to get the wound to the point that we could use a skin graft to close it. Yesterday, that changed. He is doing everything right, including being vigilant about controlling his diabetes. The bottom of his foot is close to healing on its own...without a skin graft! This is ideal, since that would make the skin much thicker and would minimize the risk of breaking open again. Thinking where we were just a few short months ago, I'm staggered to think that soon he'll be back to wearing shoes and even back to work with two functioning feet.

Good thing we decided not to take the easy way out by amputating the leg, don't you think?