{"id":107,"date":"2016-05-19T15:06:41","date_gmt":"2016-05-19T19:06:41","guid":{"rendered":"http:\/\/www.mainefootcare.com\/?page_id=107"},"modified":"2016-05-19T15:26:50","modified_gmt":"2016-05-19T19:26:50","slug":"diabetic-foot-care","status":"publish","type":"page","link":"https:\/\/mainefootcare.com\/?page_id=107","title":{"rendered":"Diabetic Foot Care and Wound Care"},"content":{"rendered":"<p><strong>What is a Diabetic Foot Ulcer?<\/strong><\/p>\n<p>A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot \u00a0with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication.<\/p>\n<p>Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States, and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer have an amputation. Research, however, has shown that the development of a foot ulcer is preventable.<br \/>\n<strong>Who Can Get a Diabetic Foot Ulcer?<\/strong><\/p>\n<p>Anyone who has diabetes can develop a foot ulcer.\u00a0 Native Americans, African Americans, Hispanics and older men are more likely to develop ulcers. People who use insulin are at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.<br \/>\n<strong>How do Diabetic Foot Ulcers Form?<\/strong><\/p>\n<p>Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot\u00a0deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes.\u00a0Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling in the feet due to nerve damage caused by elevated blood glucose levels over time.\u00a0The nerve damage often can occur without pain and one may not even be aware of the problem.\u00a0Your podiatric physician can test feet for neuropathy with a simple and painless tool called a monofilament.<\/p>\n<p>Vascular disease can complicate a foot ulcer, reducing the body\u2019s ability to heal and increasing the risk for an infection.\u00a0Elevations in blood glucose can reduce the body\u2019s ability to fight off a potential infection and also retard healing.<br \/>\n<strong>What is the Value of Treating a Diabetic Foot Ulcer?<\/strong><\/p>\n<p>Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers in patients with diabetes should be treated for several reasons such as, reducing the risk of infection and amputation, improving function and quality of life, and reducing health care costs.<br \/>\n<strong>How Should a Diabetic Foot Ulcer be Treated?<\/strong><\/p>\n<p>The primary goal in the treatment of foot ulcers is to obtain healing as\u00a0soon as possible. The faster the healing, the less chance for an infection.<\/p>\n<p>There are several key factors in the appropriate treatment of a diabetic foot ulcer:<\/p>\n<ul>\n<li>Prevention of infection.<\/li>\n<li>Taking the pressure off the area, called \u201coff-loading.\u201d<\/li>\n<li>Removing dead skin and tissue, called \u201cdebridement.\u201d<\/li>\n<li>Applying medication or dressings to the ulcer.<\/li>\n<li>Managing blood glucose and other health problems.<\/li>\n<\/ul>\n<p>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.<\/p>\n<p>There are several important factors to keep an ulcer from becoming infected:<\/p>\n<ul>\n<li>Keep blood glucose levels under tight control.<\/li>\n<li>Keep the ulcer clean and bandaged.<\/li>\n<li>Cleanse the wound daily, using a wound dressing or bandage.<\/li>\n<li>Do not walk barefoot.<\/li>\n<\/ul>\n<p>For optimum healing, ulcers, especially those on the bottom of the foot, must be \u201coff-loaded.\u201d\u00a0Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches.\u00a0These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.<\/p>\n<p>The science of wound care has advanced significantly over the past ten years.\u00a0The old thought of \u201clet the air get at it\u201d 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.\u00a0The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.<\/p>\n<p>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.<\/p>\n<p>For a wound to heal there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests.<br \/>\n<strong>Controlling Blood Glucose<\/strong><\/p>\n<p>Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. Working closely with a medical doctor or endocrinologist to accomplish this will enhance healing and reduce the risk of complications.<br \/>\n<strong>Surgical Options<\/strong><\/p>\n<p>A majority of noninfected foot ulcers are treated without surgery; however, when this fails, surgical management may be appropriate. Examples of surgical care to remove pressure on the affected area include shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony \u201cbumps.\u201d<br \/>\n<strong>Healing Factors<\/strong><\/p>\n<p>Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound. Healing may occur within weeks or require several months.<br \/>\n<strong>How Can a Foot Ulcer be Prevented?<\/strong><\/p>\n<p>The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis.\u00a0 He or she can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.<\/p>\n<p>You are at high risk if you:<\/p>\n<ul>\n<li>have neuropathy,<\/li>\n<li>have poor circulation,<\/li>\n<li>have a foot deformity (i.e., bunion, hammertoe),<\/li>\n<li>wear inappropriate shoes,<\/li>\n<li>have uncontrolled blood sugar.<\/li>\n<\/ul>\n<p>Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose are important in the prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks.\u00a0Your podiatric physician can\u00a0provide guidance in selecting the proper shoes.<\/p>\n<p>Learning how to check your feet is crucial in noticing a potential problem as early as possible. Inspect your feet every day\u2014especially between the toes and the sole\u2014for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health care provider, remove your shoes and socks so your feet can be examined.\u00a0Any problems that are discovered should be reported to your podiatrist as soon as possible, no matter how \u201csimple\u201d it may seem to you.<\/p>\n<p>The key to successful wound healing is regular podiatric medical care to ensure the following \u201cgold standard\u201d of care:<\/p>\n<ul>\n<li>lowering blood sugar<\/li>\n<li>appropriate debridement of\u00a0wounds<\/li>\n<li>treating any infection<\/li>\n<li>reducing friction and pressure<\/li>\n<li>restoring adequate blood flow<\/li>\n<\/ul>\n<p>The old saying, \u201can ounce of prevention is worth a pound of cure\u201d was never as true as it is when preventing a diabetic foot ulcer.<\/p>\n","protected":false},"excerpt":{"rendered":"What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot \u00a0with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication. Diabetes is the leading cause of nontraumatic lower [&hellip;]","protected":false},"author":1,"featured_media":0,"parent":116,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"nf_dc_page":"","footnotes":""},"class_list":["post-107","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/pages\/107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mainefootcare.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=107"}],"version-history":[{"count":2,"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/pages\/107\/revisions"}],"predecessor-version":[{"id":109,"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/pages\/107\/revisions\/109"}],"up":[{"embeddable":true,"href":"https:\/\/mainefootcare.com\/index.php?rest_route=\/wp\/v2\/pages\/116"}],"wp:attachment":[{"href":"https:\/\/mainefootcare.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}