Frequently Asked Questions
Frequently Asked Questions: Diabetic Foot Ulcers
1.What Is a Diabetic Foot Ulcer?
- It is an open sore or wound on the foot of a patient with diabetes, most commonly located on the plantar aspect, or bottom of the foot. Diabetic foot ulcers occur in approximately 15% of patient with diabetes. Between 14-24% percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulcer is preventable if the underlying conditions causing it, diabetic peripheral neuropathy and/or peripheral arterial disease, are appropriately diagnosed and treated.
2.How Do Diabetic Foot Ulcers Form?
- It is formed due to various factors like sensation loss in foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection. Elevations in blood glucose can reduce the body’s ability to fight off a potential infection and also retard healing.
3.Why to treat a Diabetic Foot Ulcer?
- To reduce the risk of infection and amputation
- To improve function and quality of life
- To reduce health care costs
4.Why to treat a Diabetic Foot Ulcer?
- The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing of the wound, the less chance for an infection. There are several key factors in the appropriate treatment of a diabetic foot ulcer:
- Managing blood glucose and other health problems.
- Prevention of infection.
- Applying medication or dressings to the ulcer.
- Taking the pressure off the area, called “Off-loading” Both Internal and external offloading.
- Removing dead skin and tissue, called “debridement”
5.Is Antibiotic Therapy Indicated for All Patients With Diabetic Foot Ulcer?
- Antibiotic therapy is indicated only in patients whose foot ulcer shows signs of inflammation, has purulent discharge, or has a suspected underlying osteomyelitis.
- However, when a foot ulcer persists for more than 4 weeks, even in the absence of signs of infection, careful workup should be performed. Therapy of foot ulcer should include antibiotic therapy, off-loading (removal of local irritation either by bed rest or the application of total contact cast), as well as workup for neuropathy and vascular insufficiency. Controlling the infected foot ulcer will improve foot function and quality of life, maintain health status, avoid amputation, and reduce the total cost of care