Diabetic Foot Ulcers

For diabetic patients, it is important to pay close attention to your feet because a small problem can easily become a large problem if not assesed and treated immediately.  Because diabetes decreases blood flow, injuries heal slowly.  An ulcer is a common foot injury for diabetic patients. 

Slow to heal, ulcers are skin wounds.  Because the foot experiences constant pressure, the skin often becomes callused.  When subjected to shearing forces that may cut into the skin, the callused layers of the skin may seperate and fill with fluid.  This fluid contaminates and infects the skin, resulting in a foot ulcer. 

There are four primary causes of foot ulcers:
Neuropathic—loss of sensation of the feet.  Diabetics may experience numbness in the feet that prevents detection of infections such as ulcers.
Arterial—Related to poor blood circulation to the lower extremity. This type of ulcer can be very painful and is usually found on the tips of toes, lower legs, ankle, heel, and top of the foot. It can very easily become infected.  Because diabetics experience decreased blood flow, ulcers are more likely to occur in their feet.
Venous—Related to compromised veins. These ulcers are often seen around the inside of the ankle and are slow to heal.
Decubitus—Derived from excessive and prolonged pressure on one area of the foot. The most common type of decubitus ulcer of the feet is bed sores on the backs of the heels of people confined to bed for long periods of time.

There are also four stages of ulcers, as they progress.  The four stages of foot ulcers are:
Stage 1—Characterized by reddening wounds over bony areas. The redness on the skin does not go away when pressure is relieved.
Stage 2—Characterized by blisters, peeling, or cracked skin. There is a partial thickness skin loss involving the top two layers of the skin.
Stage3—Characterized by broken skin and sometimes bloody drainage. There is a full thickness skin loss involving subcutaneous tissue (the tissue between the skin and the muscle.)
Stage 4—Characterized by breaks in the skin involving skin, muscle, tendon, and bone and are often associated with a bone infection (osteomyelitis).

As a diabetic, infections such as ulcers can spread quickly.  If you experience any numbness in your feet, it may be hard to detect injuries such as ulcers, so we recommend that you get into a routine of checking your feet everyday to make sure there aren't any abnormalities.  If you do develop any ulcers, make an appointment to come to our office as soon as possible.  Please call (419)423-1888 to schedule an appointment.