Diabetic Foot Ulcer Treatment Guidelines

Diabetes is one of the most common metabolic diseases that affect a major population of this world. It is the most common cause of diabetic wounds and nontraumatic lower limb amputations worldwide. Approximately 14 to 24 percent of patients with diabetic foot ulcers can have an amputation, i.e., the removal of the limb. Therefore it is very important to treat foot ulcers to avoid complications. 

What is Diabetic Foot Ulcer? 

A diabetic foot ulcer is an open sore or wound associated with diabetes. It is commonly found on the bottom of the foot. Diabetic foot ulcers or wounds may get infected if there may be some ulcer-related complications that can lead to hospitalization. 

Diabetic Foot Ulcer Causes 

As the name suggests, these types of ulcers usually originate because of uncontrolled diabetes. 

Diabetic Foot Ulcers form due to many factors, such as lack of any sensation in the foot, poor blood circulation, foot deformities, irritation (such as friction or pressure), and trauma or injury to the foot, as well as the duration of diabetes. 

Patients who have had diabetes for a long duration can develop Neuropathy, reduced or complete absence of any sensation in the feet due to nerve damage caused by high blood glucose levels. Nerve damage may or may not cause any pain. 

Vascular disease can be another very important factor that leads to Diabetic Foot Ulcers and its complications. Reduced blood supply to a foot can reduce the body’s ability to start the wound-healing process, which can cause an infection. High blood glucose levels suppress your immune system, which is primarily responsible for starting the healing process in your body. 

READ MORE: HOW DOES DIABETES AFFECT WOUND HEALING

Diabetic Foot Ulcer Dressing Guidelines

If a person with diabetes has a foot ulcer, he needs to take proper care of the wound to avoid infection. Proper wound management comprises the use of bandages and dressings and topically-applied ointments and creams. It would be best to avoid occlusive dressing, for it may complicate the ulcer. 

Dressings and bandages containing iodine and silver may help control the wound infection. Non Adhesive dressings are very well tolerated, so they can be used because they are inexpensive and simple to use as well. 

The healing process of our body starts when the injured part of our body has a proper circulation of blood. If the ulcerated  area is devoid of blood, you may need to amputate the limb. Your podiatrist may request evaluation tests that are non-invasive to ensure that the ulcerated area has intact circulation. 

Diabetic Ulcer characteristics

Usually, a diabetic foot ulcer is deep (at advanced stages) with necrotic areas (localized death of living tissue).

It is most regular in shape, and the edges of the wound or ulcers are even with a punched-out appearance.

Patients may have pain because of neuropathy. 

The foot may be swollen as well. 

Foot and toe ulcers differ in color. The most common colors are Yellow, Pink, Red, Grey, and Black.

If your ulcer is black, that means cells in those tissues of your foot have died, which is called necrosis (gangrene).

Diabetic Foot Ulcer Treatment Guidelines

The primary objective in managing and treating foot ulcers is to make the healing process occur as soon as possible. The faster the healing of the wound, the lesser will be the chance for the development of an infection.

The treatment of diabetic foot ulcers is more or less similar to the treatment of pressure ulcers. Still, there are a few differences that make treatment and management of diabetic foot ulcers a priority. 

There are several key factors in the appropriate treatment of a diabetic wound or ulcer at any site of the body, specifically of a diabetic foot ulcer:

• Prevention of infection
• Taking the pressure off the area is called “off-loading.”
• Removing dead skin and tissue which is called “debridement.”
• Applying medication or bandages to the ulcer
• Controlling blood glucose and other health problems

READ ALSO: A COMPLETE GUIDE TO DIABETES WOUND HEALING AND TREATMENT

Diabetic Foot Ulcer Diet

To control and prevent the complication of diabetic foot ulcers, one needs to control diabetes which means he has to consume foods that can help him maintain his blood sugar levels. 

So if you are wondering what foods are the best to eat, here’s a list of foods you can eat. 

Protein-rich foods, including:

• Lean meats and seafood
• Skinless poultry
• Eggs
• Tofu

Whole-grain and high-fiber carbohydrates, such as:

• Whole-grain slices of bread, cereals, and pasta
• Brown rice
• Beans
• Fruits with the skin
• Berries
• Low-fat dairy products

Non-starchy vegetables, such as:

• Cauliflower
• Tomatoes
• Carrots
• Broccoli
• Cabbage
• Spinach

Diabetic Foot Ulcer Home Treatment

The cure of all ulcers begins with thorough skin and foot care. You need to inspect your skin, especially the undersurface of your foot, regularly to see if any ulcer is growing or not. If you notice an ulcer on your foot, immediately contact a doctor. Inspecting your skin is very crucial, especially for people with diabetes. If you can detect and treat foot and toe sores early, it can help you prevent infection and keep the sore from getting worse.

A few treatments or remedies are useful in preventing the infection of ulcers. 

• Topical wound care and wound healing creams. 
• Ulcers have less chance of getting infected, and they heal faster if they’re kept covered and moist.
• Homeopathic medicines (they may or may not be effective)
• Antibiotics.
• Antiplatelet or anti-clotting medications.

• Compression clothes.
• Draining.
• Prosthetics.
• Orthotics.
• Removing pressure from the area by wearing a cast, a certain shoe, or braces decreases the pressure on such ulcers so they can heal easily and quickly. 
• Elevation of the foot.

Diabetic Ulcer on Big Toe

Diabetic ulcers on the Big toe are also caused because of elevated blood sugar levels, which decrease the vascularity and blood circulation to your toes and can cause the development of ulcers there. These ulcers can be painless or painful. They can appear necrotic, which indicates the death of the tissue of the toe. 

Diabetic Foot Ulcer Antibiotics 

The ulcers can get infected by several bacteria, and because of their location and easy exposure, it is very easy for diabetic foot ulcers to get infected.

You can use certain antibiotics for the infection, like dicloxacillin, cephalexin, and clindamycin, all of which are given through oral routes (tablets, etc.).

Severe soft tissue disease or infection can be originally treated intravenously with ciprofloxacin plus clindamycin; piperacillin/tazobactam; or imipenem/cilastatin and all of the drugs as mentioned above are antibiotics. 

Laser Treatment For Diabetic Foot Ulcer 

A modern and alternative treatment to heal diabetic foot ulcers non-invasively is laser therapy. It’s a painless procedure that uses a safe laser beam to stimulate the body’s healing mechanism. 

In Pakistan, BioFlex Laser Therapy is providing this modern treatment with no side effects at all. We have experienced doctors, well-trained staff, and advanced equipment to treat diabetic foot ulcers.