Diabetic Foot Ulcers
Ulcers are defects in the skin layers that result in an open wound. The most common type of skin ulcer is due to diabetes and they normally happen on the bottom part of the foot. This condition needs to be treated aggressively because there is a potential for progression of the disorder to get worse. This can lead to infection of skin and other soft tissues (like cellulitis) or infections can get deeper and infect bone or tendons. If bone gets infected the diagnosis is called “osteomyelitis” and treatment is extremely complex.
Common causes of ulcers include poorly fitting shoes, trauma, and long periods of laying in bed.
Common conditions associated with ulcers include neuropathy, diabetes and peripheral vascular disease (poor blood flow).
Standard treatment of an ulcer includes appropriate dressing changes, debridement (cleaning the wound), and offloading (using the correct boot or shoe to minimize pressure).
The best approach to obtain healing means getting multiple specialists involved in your care. This may include your podiatrist, primary care doctor, endocrinologist, vascular surgeon, interventional radiologist, nutritionist among others.
In some cases advanced approaches may be necessary like grafting of the ulcers. This can be done either in the operating room or conveniently, in some cases, in the clinical setting.
If your ulceration is complex this may require referral to a wound care center.