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Don't Forget What's Underfoot


Diabetes is a major health concern worldwide. Complications of this disease can lead to diabetic foot ulcers. It is estimated that 15% of diabetic patients develop a foot ulcer in their lifetime. This article will shed light on the topic of diabetic foot ulcers, and what can be done to reduce your risk for further complication.

Risk factors associated in the development of diabetic foot ulcers include diabetic neuropathy, peripheral vascular disease, cigarette smoking, poor glycemic control, and ischemia (blood restriction) of small and large blood vessels. These foot ulcers commonly appear as blisters or sores on the top, bottom and heel of the foot. As a result of pressure or unnoticed injury, these foot ulcers eventually become a gateway for bacteria and infection. 

The first step in foot ulcer management is to establish the nature of the ulcer. Your podiatrist can take a plain-film radiograph to evaluate bone involvement. Your podiatrist can also debride (remove) all dead and infected surrounding tissue until a healthy bleeding edge is revealed. Lastly, the ulcer can be probed or felt by a podiatrist with a sterile blunt instrument to determine the involvement of underlying structures, such as tendon, joint capsule or bone. Once your podiatrist evaluates the severity of your wound, appropriate treatment will ensue.

Treatment of diabetic foot ulcers includes the following:

  • Prevention of infection
  • Taking the pressure off the area, called “off-loading”
  • Removing dead and infected tissue
  • Application of wound dressings and absorptive fillers, such as hydrogel dressings and hydrocolloids.
  • Platelet-Rich Fibrin Therapy
  • Negative pressure wound therapy
  • Managing blood glucose and associated health problems

Since not all ulcers are infected, if your podiatrist diagnoses an infection, therapy consisting of antibiotics, wound care, and possibly hospitalization will be necessary.

Preventative measures can be taken to keep an ulcer from becoming infected, such as:

  • Keep blood glucose levels under tight control
  • Keep the ulcer clean and bandaged, and cleanse the wound daily using a wound dressing
  • Avoid walking barefoot. If possible, try to wear custom made off-loading footwear.

Foot Care Associates has three different business locations in Hackettstown, Landing, and Washington. For professional diagnoses and management of your foot ulcer, be sure to make an appointment with Dr. Mullen.

By John Guiliana

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