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
Like our facebook fan page: http://www.facebook.com/drmichelesummerscolondpm
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
Showing posts with label diabetic wound. Show all posts
Showing posts with label diabetic wound. Show all posts
Friday, September 28, 2012
Tuesday, June 26, 2012
Diabetic Foot Infections Can Kill You!
Do you or someone in your family have diabetes? Ignoring your feet can kill you! Take a listen, save a life!
Sunday, December 6, 2009
So what exactly is a Diabetic ulcer and why is it so bad?
Those with diabetes and their friends and family members have at one point and time heard the term “diabetic ulcer”. And it is usually followed by “that’s why their foot was amputated”. So what is a diabetic ulcer?
An ulcer is any break in the skin that does not heal in a reasonable amount of time, usually a week to 10 days. This can occur anywhere, not just the feet. But for diabetics, the feet are the most common place for ulcerations to occur. This is due to 2 problems: neuropathy and pressure.
Neuropathy is the loss of sensation that can occur with long term or uncontrolled diabetes. Once you cannot feel things like heat, friction or pain, then any area of pressure can form a callus on the foot. When this callus is present for several days to weeks without being treated, the skin under the callus becomes soft and breaks down, resulting in an ulcer. This is now an all access pass for bacteria to enter the body and cause infection. That infection, if left untreated, can cause loss of part or all of the foot or leg.
I often have patients that tell me they attempted to treat the ulcer for several days to weeks before coming in the office. They applied Neosporin and washed it every day, but it just wasn’t getting better. To treat an ulcer effectively, several things need to occur. First and foremost, stop any infection that may be brewing or already started. No ulcer will heal if it is infected. This is done with topical ointments that are more effective at treating infection than Neosporin and antibiotics. Next, removing any tissue that may be harboring bacteria and also slowing down the healing progress of the ulcer. Lastly, take away the pressure. If an ulcer has constant pressure applied, then good healthy skin cannot grow over it to heal. So using special offloading boots or shoes to reduce the pressure is crucial in treating the wound.
Other factors in treating your ulcer include keeping your sugars in control and eating a well balanced diet. With high sugars, the body has a great deal of trouble healing any wound and it has a harder time fighting off infection. Remember….bacteria loves sugar!!
Once the ulcer is healed, the next step is preventing another one. If you haven’t seen a podiatrist and you are diabetic, now is the best time to have those feet checked for any signs that an ulcer could form. If you have had an ulcer in the past and have not seen your podiatrist in over a year, get on the phone and make an appointment! Prevention is the key to saving your feet!
An ulcer is any break in the skin that does not heal in a reasonable amount of time, usually a week to 10 days. This can occur anywhere, not just the feet. But for diabetics, the feet are the most common place for ulcerations to occur. This is due to 2 problems: neuropathy and pressure.
Neuropathy is the loss of sensation that can occur with long term or uncontrolled diabetes. Once you cannot feel things like heat, friction or pain, then any area of pressure can form a callus on the foot. When this callus is present for several days to weeks without being treated, the skin under the callus becomes soft and breaks down, resulting in an ulcer. This is now an all access pass for bacteria to enter the body and cause infection. That infection, if left untreated, can cause loss of part or all of the foot or leg.
I often have patients that tell me they attempted to treat the ulcer for several days to weeks before coming in the office. They applied Neosporin and washed it every day, but it just wasn’t getting better. To treat an ulcer effectively, several things need to occur. First and foremost, stop any infection that may be brewing or already started. No ulcer will heal if it is infected. This is done with topical ointments that are more effective at treating infection than Neosporin and antibiotics. Next, removing any tissue that may be harboring bacteria and also slowing down the healing progress of the ulcer. Lastly, take away the pressure. If an ulcer has constant pressure applied, then good healthy skin cannot grow over it to heal. So using special offloading boots or shoes to reduce the pressure is crucial in treating the wound.
Other factors in treating your ulcer include keeping your sugars in control and eating a well balanced diet. With high sugars, the body has a great deal of trouble healing any wound and it has a harder time fighting off infection. Remember….bacteria loves sugar!!
Once the ulcer is healed, the next step is preventing another one. If you haven’t seen a podiatrist and you are diabetic, now is the best time to have those feet checked for any signs that an ulcer could form. If you have had an ulcer in the past and have not seen your podiatrist in over a year, get on the phone and make an appointment! Prevention is the key to saving your feet!
Saturday, July 18, 2009
How Should a Diabetic Foot Ulcer be Treated?
The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection.
There are several key factors in the appropriate treatment of a diabetic foot ulcer:
•Prevention of infection.
•Taking the pressure off the area, called “off-loading.”
•Removing dead skin and tissue, called “debridement.”
•Applying medication or dressings to the ulcer.
•Managing blood glucose and other health problems.
Not all ulcers are infected; however if your podiatric physician diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
There are several important factors to keep an ulcer from becoming infected:
•Keep blood glucose levels under tight control.
•Keep the ulcer clean and bandaged.
•Cleanse the wound daily, using a wound dressing or bandage.
•Do not walk barefoot.
For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches. These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.
The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.
Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.
For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.
There are several key factors in the appropriate treatment of a diabetic foot ulcer:
•Prevention of infection.
•Taking the pressure off the area, called “off-loading.”
•Removing dead skin and tissue, called “debridement.”
•Applying medication or dressings to the ulcer.
•Managing blood glucose and other health problems.
Not all ulcers are infected; however if your podiatric physician diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.
There are several important factors to keep an ulcer from becoming infected:
•Keep blood glucose levels under tight control.
•Keep the ulcer clean and bandaged.
•Cleanse the wound daily, using a wound dressing or bandage.
•Do not walk barefoot.
For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches. These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.
The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.
Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.
For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.
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