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Diabetic Foot Ulcers Tips to manage foot and to ulcers in diabetic patients

What are ulcers?

Ulcers are the wounds, sores, or lesions in your skin that are mostly found on your feet and toes. They usually do not heal on its own and can get infected. Even after treatment, it might take months for such wounds to heal.

Types of foot ulcers

Depending on the location and appearance of surrounding skin and borders, ulcers are categorized into three types:

Arterial ulcers: Observed all over the feet in patients with blood circulation issues. Lack of blood supply can result in small wounds or cuts failing to heal, and in due course turning into ulcers.

Venous ulcers: This is observed in people with vein related problems. As the veins in your legs do not push blood back up to your heart as effectively as they should, open sores are formed which mostly affects the legs, above the ankle. 

Diabetic foot ulcers: Diabetic foot ulcers are formed when the skin tissue in the foot breaks down and exposes the layers beneath. When diabetes is not managed properly with diet, exercise, and treatments, several complications may occur. One major complication is the foot ulcer that is commonly found at the bottom of the feet. 

Among these, diabetic foot ulcer is one of the most devastating and significant complications of diabetes. It is estimated that about 15 % of people with diabetes will get a foot or to ulcer. A significant proportion (between 14- 24 %) will require an amputation after they get an ulcer.  

Who can get a diabetic foot ulcer?

Studies have shown that diabetic foot ulcers can occur at any age but are most prevalent in patients aged 45 and over having diabetes mellitus.

Patients with diabetes-related kidney, eye, and heart disease who use insulin are at a higher risk of developing foot ulcers.

Obesity, lifestyle behaviors like tobacco and alcohol use, heart, or kidney disease, can also increase the risk of ulcer formation.

Initial stage is the formation of a callus that results from neuropathy. Physical deformity of foot and sensory loss leading to ongoing trauma can occur. Skin turns excessively dry, finally resulting in hemorrhage which erodes and turns into an ulcer. 

Laboratory Testing and evaluations 

Fasting blood sugar, hemoglobin levels, complete metabolic panel, a complete blood count, ESR, and C-reactive protein (CRP) are few most common investigations performed during evaluation of the ulcer. 

Treatment for foot ulcers

From a history of chills, fever, presence of signs of inflammation that include pain, warmth, erythema or sclerosis of the ulcer, the evidence of ongoing infection is identified. Antibiotics will be administered if there is any concern of infection. Dose, type, and duration of antibiotics will be decided based on the severity of infection.

Another therapeutic step is to treat the underlying vascular disease. Inadequate blood supply that limits the oxygen supply and the delivery of the antibiotics to the ulcer can improved by revascularization and there is an improved chance of healing of the ulcer. Subsequently, local debridement or removal of calluses is performed.

For best results, a team of healthcare providers including a physician, podiatrist, a vascular surgeon, and wound care nursing staff are imperative during the ulcer treatment.

Venous Ulcer Treatment Hyderabad | Vijayawada | Visakhapatnam

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