Preventing and Treating Foot Ulcers | Amputation Prevention Centers

Treating Foot Ulcers
With foot ulcers occurring in approximately 15 percent of patients with diabetes. Preventing and treating foot ulcers when they occur can be an important part of your health routine.

In addition to foot ulcers, if you have diabetes, your risk of amputation is 28 times higher than someone without the condition. Consequently, successfully avoiding foot ulcers or ensuring prompt healing can help you avoid the problem.

Preventing Foot Ulcers

Staving off a foot ulcer is the most beneficial option. To ward them off, follow these steps:

  1. Manage blood sugar: Before eating keep your blood sugar at 80-130 mg/dL before meals and under 180 mg/dL after. A healthy blood sugar level encourages faster healing.
  2. Pamper your feetConduct daily foot inspections, using a mirror to see the bottoms of your feet, if necessary. Look for cracks, cuts, blisters, and other signs of wounds. Wash your feet daily with mild soap and warm water. Dry thoroughly, especially between your toes, and apply talcum powder to deter blisters.
  3. Pick the right shoes: Select shoes that are tight enough to keep fabric from rubbing your skin, causing an ulcer. But, choose ones loose enough to not crowd your toes and be comfortable. If you need them, choose orthopedic shoes that can be custom fitted to the size, shape, and contours of your feet.
  4. Don’t light up: Don’t smoke. It reduces your circulation, making your blood flow problems worse. It can also decrease the feeling in your feet.
  5. See your doctor: Have a foot exam at least once a year to inspect your feet for circulatory issues, early signs of nerve damage, or other foot problems.

 

Treating Foot Ulcers

If you do develop a foot ulcer, there are therapeutic options available. Discuss the best tactic with your doctor.

  1. Debridement: This is the surgical removal of unhealthy tissue and bacteria from the wound in order to promote healing.
  2. Hyperbaric Oxygen Therapy (HBOT): HBOT works by delivering 100% pure oxygen to a patient through increased atmospheric pressure in a large, clear, acrylic chamber. This increased oxygen absorption enhances the body’s ability to heal.
  3. Living Cellular Skin Substitute: This therapy consists of the application of products made of living cells and proteins that can, over time, stimulate wound healing.

Within 4 weeks, if you haven’t healed — or if you have developed a bone infection — consult your doctor.

Be aware, foot ulcers can start small with a callus or a blister. Be sure the keep your weight off the affected foot as much as possible to avoid any worsening of your ulcer. Be vigilant. The soft tissue of your foot is susceptible to infection, so any problems can spread to muscle and bone quickly. If you notice any changes or problems, contact your doctor. Delayed treatment can slow down healing and even lead to amputation.

Contact the Amputation Prevention Centers of America for more information on preventing and treating foot ulcers.

Treating Charcot Foot: Surgery or Not?

Treating Charcot Foot
If you have peripheral neuropathy, there’s a chance you could also develop Charcot foot. This condition weakens the bones of your foot, as well as your joints and soft tissues, while causing painful sores or changing the shape of your foot.

As many as 2.5 percent of patients with diabetes can develop Charcot foot, and it can recur in as many as five percent of cases.

Fortunately, your doctor can help you in treating Charcot foot, largely reversing the damage it causes. Depending upon the severity of your case, you could receive medical or surgical therapy. Any treatment option you receive will have similar goals: take weight off the injured foot, address bone disease, and prevent future foot fractures.

Charcot Foot Diagnosis 

Imaging scans can help your doctor determine what treatment type you need. X-rays offer detailed pictures of dense structures, such as bones. MRI and ultrasound provide good imaging of foot and ankle soft tissues, potentially identifying any bone infections. Bone scans are nuclear tests that can also identify bone infections. A specific test — an indium scan — tags your white blood cells and follows them to the infection site.

Treating Charcot Foot

Whether your doctor recommends surgical or non-surgical treatment, you will get the best long-term results if you closely follow your physician’s instructions. Most specifically, wait until he or she tells you it’s safe to put weight on your foot again.

Also, be sure to check your feet daily for any problems, including scrapes or lingering sores. If any exist, immediately contact your doctor. The sooner you get treatment, the more likely you are to have a good outcome.

Non-surgical treatment: Offloading — keeping your weight off your affected foot — is the most important part of treating Charcot foot without surgery. For anywhere from 8-to-12 weeks, you’ll wear a protective walking boot or cast. The protective footwear should stay in place until any redness, swelling, or heat disappears. The Charcot Restraint Orthotic Walker (CROW) is a commonly used device.

The second step is prescription orthotic shoes. These shoes must fit appropriately, providing enough room for your toes and enough cushioning for the heel, arch, and ball of your foot. The right shoes won’t have any pressure points, reducing the risk of injury or ulcers.

You’ll also need to change your activities to avoid repetitive trauma to both feet.

Surgical treatment: Surgery is recommended for individuals with severe ankle and foot deformities that could make using a brace or other orthotics difficult. These patients are also at a higher risk for developing foot ulcers.

Surgery could involve re-aligning the bones of your foot or removing some that could cause ulcers. According to recent research, most patients with diabetes are able to resume normal walking after surgery.

Because infection risk is high post-surgery, you’ll be instructed not to put your full weight on your foot until your doctor gives you the green light. You’ll also need to commit to wearing protective footwear for life.

Remember, it is possible for Charcot foot to return, so stay vigilant with your foot hygiene.

For more information on treating Charcot foot, contact the Amputation Prevention Centers of America.