Posts for: November, 2018
If you’re diabetic, you’ve probably heard about diabetic ulcers. Poor health, injury, and lack of self-care can lead to serious ulcerations on the feet that could necessitate drastic action, such as an amputation. But what is an ulcer? How do they form? And how do you avoid them? Keep reading. We’ve got your answers.
What is a foot ulcer?
In the simplest terms, an ulcer is a sore or an open wound. Minor foot ulcerations affect only the top layers of skin. Deep ulcerations may extend through the skin into the tissue or bone underneath. The area will appear as a red “crater” with a border of toughened skin surrounding it.
How does a foot ulcer form?
Foot ulcers usually form from a small abrasion or cut that goes unnoticed or untreated. Over time, as shoes and everyday activities put pressure and friction on this spot, it will open into an ulcer.
Who gets foot ulcers?
Diabetics and other persons with neuropathy or circulation issues are at the highest risk for foot ulcers. Neuropathy may cause a cut to go unnoticed, growing into an ulcer. Circulation issues prevent blood flow and oxygenation of the tissues that would help with healing. Diabetic patients often suffer from circulation issues and neuropathy, which makes them the highest at-risk group.
How does a foot ulcer heal?
Due to their placement—often on the bottom and sides of the foot—ulcers take a long time to heal and can easily become infected. An ulcer caught in the early stages in a person with few risk factors or complications can heal itself with proper treatment in three to six weeks. Deep ulcers and ulcers in people with risk factors and other health conditions may take up to 20 weeks to heal. Surgical intervention may be necessary, especially if the ulcer becomes infected.
When do foot ulcers become dangerous?
Ulcers are particularly dangerous because of the high risk of infection. In an area of the body that’s already having trouble healing itself, an infection can spell big trouble and require surgical intervention. Infections can become abscesses (pus pocket), bone infections (osteomyelitis), and even gangrene (dead, darkened tissue).
What are the treatment options?
The number one treatment for foot ulcers is off-loading or staying off the affected foot. Your podiatrist may also recommend wearing shoe inserts, compression wraps, foot braces, casts, or diabetic shoes. Ulcers can be debrided, which removes the dead skin and cleans the wound. An infected foot ulcer may be treated with antibiotics or more drastic action may be taken, such as cutting away infected tissue. In a worst-case-scenario, amputation may become necessary.
How do I avoid getting a foot ulcer?
Avoiding foot ulcers is easy if you perform a daily foot inspection, maintain proper foot hygiene, and wear properly fitting socks and shoes. Keep an eye on corns, calluses, cuts, cracks, and abrasions.
If you or a loved one are suffering from or suspect a foot ulcer, call the FAAWC immediately. Early treatment is key to a shorted healing time and avoiding extreme outcomes such as amputation.
Today, most people are aware of the harmful effects of smoking, particularly related to lung and heart health. But did you know smoking can impact the health of your feet?
The harmful chemicals in cigarettes, like carbon monoxide and nicotine, break down layers of cells in your blood vessels, which causes plaque and fat to build up in the vessel walls. This, in turn, can narrow and block arteries throughout the body, preventing adequate blood supply from reaching your feet. When this impacts the arteries in your extremities (arms and legs), it is called Peripheral Arterial Disease (PAD).
Restricted blood flow can also prevent the nerves in your feet from sending signals to the brain, which can cause peripheral neuropathy. Peripheral neuropathy can result in numbness, tingling, and a prickling feeling in the feet and legs. It can also prevent the communication of pain signals between the feet and the brain. For example, someone with peripheral neuropathy may not feel pain from a blister forming on the foot. If they aren’t performing daily foot self-examinations, it could continue to go unnoticed until it develops into an ulcer. This is a common occurrence, with as many as one in four diabetics developing a foot ulcer.
Ulcers are sores that appear as craters in the surface of the skin. The skin around the ulcer may be red and inflamed or rough and callused. If left untreated, a foot ulcer can quickly grow and impact the muscles, tendons, and bones of the foot. Infections, such as gangrene, can set in and cause additional complications. Those with diabetes and poor circulation are at a higher risk for ulcers. Between 14 and 24% of diabetics who experience an ulcer will require an amputation of the infected toe, a portion of the foot, or even the entire foot.
Because peripheral neuropathy is characterized by a lack of feeling, symptoms can go unnoticed. Circulation issues, such as PAD, are also easily dismissed or misdiagnosed since the most common symptoms—leg cramping, numbness, and tired or sore muscles—can also be attributed to the pains of everyday life.
There is good news! Lifestyle changes such as smoking cessation, exercising, and healthy eating can all help reduce or reverse symptoms of poor circulation and peripheral neuropathy. If you are a diabetic, especially one who smokes, talk to your podiatrist today about your foot health.
It’s never too early to learn about your risk factors and work on a prevention or treatment plan for your pains. Call the FAAWC today to book your appointment.
Foot inspections are an important part of total-body health and wellness, but too many people forego this important routine on the assumption that if they aren’t in pain, their feet are fine. The best way to ensure continued foot health is to complete regular foot self-examinations.
The average person should complete a thorough foot inspection weekly. Diabetics, who are at a much higher risk for foot complications, should perform this check daily. Before you get started, you’ll need a hand mirror and a stiff, monofilament wire for the sensitivity test.
Wash your feet—don’t just let the shower water rinse your feet as an afterthought. Instead, rub lightly with soap and a loofah to remove dead skin cells and promote smooth skin. Washing your feet regularly helps avoid infections.
Sit somewhere comfortable and maintain balance while checking the tops and sides of your feet for cuts, discolorations, and calluses. Check the bottoms of your feet for warts, discolorations, and abrasions. If you have trouble seeing the bottom of your foot, place a mirror on the ground and hold your foot over it during the examination.
Check between the toes for corns, calluses, injuries, and skin changes that could indicate a fungal infection.
Test your foot sensitivity with a short monofilament wire. This device is used to place light pressure on different parts of the foot to gauge sensitivity. As sensitivity decreases, balance issues can develop, and small wounds can go unnoticed until it’s too late and amputation is necessary.
Look for Changes—run your hands over the sides, top, and bottom of your bare foot. The first few times, you may not feel anything, but over time, you’ll be better prepared to recognize something abnormal feeling. Look for lumps and bumps, but don’t ignore the underlying structure of the foot as well. Anything that looks questionable should be seen by a podiatrist right away.
Everyone should be performing a foot self-examination weekly, but diabetic patients need to be more diligent in their observations and check their feet daily. The two biggest problems with diabetic feet are neuropathy (loss of feeling) and peripheral vascular disease (a circulatory issue).
These conditions increase the risk of diabetic foot issues such as ulcers and amputation, but a thorough self-examination of about 5-15 minutes daily can help prevent and reduce complications from any foot problems that may arise. To assist in protecting your feet, try diabetic socks (something with recessed seams) and shoes (should be properly fitted and prescribed by your podiatrist).
There’s a lot you can do for your feet, but you have to actually pay attention to them to protect them. Everyone should perform a self-examination of their feet weekly, and diabetics should complete this daily. It’s like flossing—if you can just make it a habit you’ll get better reports from your podiatrist and your feet will be happy.