Foot ulcer is mainly occur due to the uncontrolled diabetes, which is formed as a result of skin tissue break down. Foot Ulcers are mostly found under big toes and the balls of your feet, and they can disturb your feet down to the bones. Diabetic foot ulcer is a reflection of DIABETES MELLITUS and perhaps the main component of the diabetic foot.
What is Foot Ulcer?
Ulcers are slow recovering incisions on the skin. Diabetic foot ulcers occur on the feet of people with type 1 and type 2 diabetes. Up to 15% of people with diabetes are at danger for developing foot ulcers. Diabetic foot ulcers usually develop on the bottom of the foot. Foot ulcers are a major global healthcare problem. It is estimated that each year around 4 million people get a foot ulcer. A foot ulcer is effected by a trauma to the foot in addition with nerve impairment and blood circulation problems.
Chronic foot ulcers mainly disturb the old person. If correlate with poorly controlled medical problems, it may lead to the loss of leg.
What is Diabetes Mellitus a Path to Foot Ulcer?
Diabetes mellitus (DM), is a complication of severely uncontrolled high blood sugar levels due to waste period of time. Increase of high blood sugar incorporate monotonous urination, increased thirst, and increased hunger. If left undiagnosed, diabetes can cause many problems.
Serious problem can possibly lead to death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and outrage to the eyes.
Diabetes is caused due to any of the two i.e. the pancreas not secreting enough insulin or the cells of the body not responding properly to the insulin secreted. There are three main types of diabetes mellitus:
- TYPE 1 results from the pancreas's failure to secrete enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is still unknown.
- Type 2 begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease causes, a loss of insulin may also develop. This form was early referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common element is over body weight and not good exercise.
- Gestational diabetes is third and important part of diabetes which mainly occurs in women during their pregnancy without any last experience of diabetes.
Sign and Symptoms:
Diabetic foot ulcers almost always occur on the edge of the feet, where skin is on to regular pressure. Under the weight of the body, skin crumbles and finally becomes an open sore. These ulcers frequently form beneath occur and cannot be felt due to diabetic neuropathy. Signs of a foot ulcer include:
- Swelling, paleness, and warmth around the wound
- Foul-smelling discharge blooding from the wound
- Pain and inflexibility when the wound is touched
- brutalized or thickened skin surrounding the ulcer
- Fever and bite in advanced stages of foot ulcers
Foot ulcer is a scratching or piercing cut on the foot. It looks like a whole or open aching in the skin as if the superficial of the tissue has been collapsed. In most people such a wound heals up within a week or two. However, when there is a hidden problem such as poorly controlled diabetes, the skin does not heal and results in a leg ulcer. Foot ulcer also involves the surface of skin, thickness of skin, bones and tendons. It is marked by inflammation, formation of pus and glade of injured tissues. Diabetic Ulcers have a callus, thickened and raised tissue disrupting the occurrence of the ulcer. Mostly ulcers are red, shallow and with irregular edges with a crust of necrotic tissue exceptional the ulcer bed.
Ischemic ulcer has a punched out appearance, smooth edges and a pale base.
There are different types of foot ulcer:
Neuropathic ulcers Diabetic ulcers: These are commonest cause for lower terminus impartation. Nerve damage results in impaired impression in the feet. When a person has an injury, blisters, or cracks on the foot, they cannot feel it. The injury can later transform into ulcer if unnoticed. Diabetic foot ulcer is a major complication of Type I & 2 diabetes. In fact it is estimated that one in every six people with diabetes will have a foot ulcer during their lifetime. Food problems involving infection, gangre and poisoning is one of the major cause of hospitalization of diabetes patient.
Arterial leg ulcers Ischemic ulcers: These approximate comprises of 10% of all leg ulcers. They are due to insufficient arterial blood supply. They usually do not bleed.
Venous leg ulcers Stasis ulcers: These are found in people who have varicose veins or blood clots. Damaged valves or blocked veins cause the blood to pool in the vein. Sometimes, the blood leaks out of the vein into the surrounding tissue, causing the tissue to breakdown and form an ulcer.
What are the places where foot ulcer occurs?
Diabetic foot ulcers usually occur on the pressure areas of the feet. The bottom of the foot, especially head of the second and fifth most assail bones. Diabetic foot ulcers can affect one's quality of life.
Arterial leg ulcers are usually found on the heels, tips of toes, between the toes or where the bones comes through out.
What are the causes of Foot Ulcer?
- Diabetes: It is the main cause of ulcer. Diabetics who won't see their feet before can suffer with the damage feet.
- Peripheral Artery Disease: Less blood reaches the feet, which bankrupt cells of oxygen and slows the foot's ability to heal. Causes include atherosclerosis fatty deposits inside arteries.
- Reynaud's phenomenon sudden episodes of decreased blood flow to the fingers and toes, among others.
- Abnormalities in the bones or muscles of the feet like fractures, claw feet, hammer toes, severe arthritis.
- Venous Insufficiency
- Injuries resulting traumatic ulcers.
- Prolonged pressure on the skin and excessive friction.
- Skin cancer squamous cell carcinoma.
- Inflammatory diseases including vacuities, lupus, scleroderma, rheumatologic conditions.
- Infections such as herpes simplex, leprosy, HIV, Epstein Barr virus.
- Genetic disorders such as Charcot Marie Tooth disease.
Preventive Measure of Diabetic Foot Ulcer?
For a person who has diabetes, checking their feet and legs every day for new or developing ulcers is critical. Early medication and care of feet is required to make it heel off quick and prevent further wounds.
Many people also report that washing and moisturizing their feet daily, giving their feet air and changing their socks regularly, wearing comfortable shoes, changing bandages often, and using products that cleanse the skin and deter bacterial and fungal growth are excellent measures for daily preventative care.
- Maintaining proper blood glucose levels to facilitate healing
- Cleaning the ulcer each day with appropriate topical ointments
- Avoiding excessive walking on your ulcerated foot
- Wearing loose-fitting shoes made of soft suede or leather with laces or Velcro fasteners.
- Check location of ulcer
- Check size of ulcer
- Check depth of ulcer
- Check out edge of the ulcer
- Check out presence of granulation tissue
- Check out discharge from the ulcer
- Check leg for varicose veins
- Check out for color changes, coldness, pain, loss of hair in legs
- Perform nylon monofilament test. The test is abnormal if the patient cannot sense the touch of the monofilament when it is pressed against the foot with just enough pressure to bend the filament
- Wearing socks that contain extra padding for protection.
- Check out the peripheral pulses in the leg
- Check Ankle brachial index ABI. It is the ratio of the systolic blood pressure at the ankle to the upper arm (brachium). Normal range is 0.9 -1.2. An ABI lesser than 0.9 is indicative of atherosclerotic disease. An ABI less than 0.3 is highly suggestive of poor chances of healing of ulcers caused by vascular insufficiency.
- Check lymph nodes in groin
Laboratory tests to be done in Foot Ulcer:
- Doppler ultrasound scan to assess blood flow and extent of vascular insufficiency
- Arteriography to define the site and degree of arterial obstruction in peripheral vascular disease
- Bone scan
- Magnetic resonance imaging (MRI)
Diabetic ulcer isn't fast recovered but can be seen improvement after the first week of treatment. An ulcer that does not heal or becomes worse should be re-evaluated by a physician as soon as possible to prevent possible complications.
If you are looking for a diabetic foot ulcer treatment, you can have your clinician contact Advanced Tissue to learn more about our range of wound care supplies that can improve wound healing.
- Treat the underlying health condition. Proper control of blood sugar, cholesterol and triglyceride levels lower foot ulcer risk.
- Examine feet every day for any cuts, blisters, or calluses.
- Keep feet clean. Wash feet daily in warm water and dry them well, especially between the toes.
- Soften your feet. Put a thin layer of lotion on the top and bottom of feet to prevent dryness.
- Trim your toenails straight across and smooth them with a file.
- Don't go barefoot. Always wear socks and shoes to avoid stepping on something and hurting your feet.
- Make sure that your shoes fit well and wear soft absorbent socks to avoid blisters.
- Exercise regularly. This improves circulation, which is very essential to fight infection.
- Stop smoking
- If you have corns or calluses, ask your doctor about how to care for them.
- If you are overweight, follow a plan to lose weight.
- Temperature control of feet can prevent ulcers in diabetics.
Tips for Patients who have recovered from Foot Ulcer:
- As recurrence rates are very high as 50%, one should be always vigilant.
- It is advised to wear customized shoes and have them evaluated on yearly basis.
- Change shoe inserts every 3-4 months.
- Have the feet examined regularly.
- Keep abreast with advances in diabetic foot care and actively participate in the treatment process with your physician.
How Diabetic Foot Ulcer Could be Treated?
If diabetic foot ulcers not treated early, then it can lead to major complication like bone infection. Advanced foot ulcers often require wound debridement, a process that carefully removes dead tissue. Doctors perform debridement in various ways, one of which is probing the wound to determine the size of the ulcer. Your doctor may also recommend at-home diabetic foot ulcer treatments that include:
Keep the ulcer dry and covered with appropriate wound dressings.
Diabetic ulcers typically experience slow wound healing, but definite improvements should be seen within a week of beginning treatment. An ulcer , if not getting healed after medication by person should take proper medication from physician so that to prevent major cause.
If you are looking for a diabetic foot ulcer treatment, you can have your clinician contact Advanced Tissue to learn more about our range of wound care supplies that can improve wound healing. Debridement to remove all necrotic tissue. This is done using surgical instruments, ointments containing enzymes or pulse lavage therapy. After debridement, the wound is irrigated with saline or cleanser and a dressing is applied.
Offloading or removing pressure from foot ulcers by avoiding walking, using crutches, wheelchair, wearing casts, braces, inserts or diabetic shoes.
Infection control: Poly microbial infections include hemolytic streptococci, pseudomonas aeruginosa, enterococci, MRSA etc. Antibiotics such as Amoxicillin and Clavulanate Potassium, Ampicillin and Sulbactam, Cephalexin, Ciprofloxacin are started after initial cultures are taken.
Honey dressings are showing promising results in ulcer treatment. Also homeopathy medicines like Hepar Sulph, Merc Sol, Silicea, Kali bichromicum are very useful.
Advance treatment for Foot Ulcer
This is advised if there is no significant improvement even after a month of treatment.
- Skin grafting
- Tissue treatment from bio-engineered human cells and collagen
- Hyperbaric oxygen therapy
- Using infrared radiation plus routine dressing is more effective according to clinical trials
- Using Therapeutic Magnetic Resonance (TMR) causes a significant increase of granulation tissue according to randomized controlled studies in three highly specialized diabetic foot clinics
- Aggressively incorporate Invasive Systemic Infection ISI
- Allergenic cellular dermal matrix treatment can accelerate wound healing and reduce complications
- Topical growth factors containing recombinant human platelet derived growth factor in gel form is used to stimulate healing
- Electrical stimulation, ultrasound, MIST therapy which uses ultrasound created mist to promote healing is used for stubborn ulcers
Home Made Remedies for Treatment of Ulcer
Not only can having diabetes lead to ulcers, it can make it very difficult for the ulcers to heal. In fact, impartations of the toes and feet are a very fair result for about 15% of diabetic patient. This underscores the absolute vital importance of daily care and attention When a wound begins to develop, keeping the area clean is priority one. Beyond that, I should say that you should go for home made lubricants or remedies so that healing would be done naturally and with zero side-effects as compared to chemical products.
Natural, raw organic honey (not the processed stuff) is one ulcer remedy that works great. Researchers have found that bandages dried up with honey can act as fast heel reliever as well as natural. Olive oil also improves the speed and quality of healing with zero side effects. Colloidal silver and Chinese herbal applications have also proven to be nice fast heel reliever as well.