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Diabetes can affect much more than a person's diet. In fact, some of their most dangerous effects are on the feet. Diabetic foot sores occur in 15 percent of patients who have diabetes. Often sores in feet are located on the bottom or side of the foot. An infection or ulcer-related issue can occur, causing the person to be hospitalized. It often results from poorly controlled diabetes. The foot ulcer is caused by the skin tissue breaking down, which can also result in a toe ulcer.
Diabetic foot ulcers require offloading — taking the advice to "take a load off" quite literally. Diabetic foot ulcer surgical shoes can help people stay on their feet without causing further damage to themselves that may require hospitalization. This special medical footwear really can be the best solution for those with ulcers on their soles.
When offloading the infected area with a post-op offloading shoe or boot is the recommended solution, OrthoTape.com can provide. Our online medical supplies store carries a full range of the Darco offloading shoes to support those with ulcers on their feet. They will assist the wearer in getting around and getting better at the same time. If you need them, order our products right away.
Causes and Treatment of Diabetic Foot Ulcers, Toe Ulcers, and Other Sores
In Feet.
Diabetes is the leading cause of foot ulcers in the world. Diabetic ulcers are often found on the sole and more commonly on the pressure
points where the foot remains in continuous contact with the ground. According
to research conducted by the American Podiatric Medical Association (APMA), it has
been estimated that approximately 15% of people with diabetes are bound to
get foot ulcers. They occur in both type 1 and type 2 diabetic patients. Their
risk of lower limb amputation increases exponentially and such individuals are
8 times more likely to undergo a definite surgical intervention. Besides that, the
mortality rate also increases if proper wound care is not ensured.
How Diabetic
Ulcers Develop?
Diabetes can cause podiatric ulcers by 2 main mechanisms:
1. Diabetic Neuropathy:
A poorly controlled blood sugar level
causes microvascular complications which especially include damage to the
peripheral nerves. If the nerves present in the feet are damaged, there is an
impending risk of complete loss of sensations. Such a patient is unable to feel
any heat or cold, vibrations, and pain and even remains oblivious to any damage
that might have occurred to his feet until it is noticed by him accidentally, or
is pointed out by somebody else. The cuts or sores remain unnoticed and can
become seriously infected which may further complicate the recovery of this
problem.
2. Peripheral Vascular Disease:
This macrovascular complication of
diabetes affects the flow of blood in the arteries and as a result, there is
poor perfusion in the body extremities. Without proper oxygenation, wounds take
a longer time to heal. The increased level of sugar also provides an optimum
environment for the pathogens to flourish. The infected wounds do not heal in
time and there is a significant risk of developing gangrene. If the sensory
function of the limbs is still intact, this can lead to severe pain in the
lower limbs.
Risk Factors
for Diabetic Foot Ulcers
All people with diabetes are prone to
develop this condition but some risk factors accentuate the onset of the problem
in very early years of life. These include the following:
1. Smoking
2. Morbid Obesity
3. Heart Disease and hypertension
4. Alcoholism
5. Poor hygiene
6. Ill-fitting and poor quality shoes
Symptoms of Diabetic Foot Ulcers
People with a longstanding history of
diabetes i.e., for more than 10 years is more likely to develop this disease.
Following are a few symptoms that one can use to better judge the ulcers on
his feet:
1.
Redness
and swelling around the wound
2.
Foul-smelling the odor from the lesions
3.
Cracks and
open lesions on the soles
4.
Foreign the material stuck in the feet
5.
Loss of
pain sensation in the feet
6.
Discharge
or pus on the socks
7.
Fever and
chills in the early stages of ulcers
8.
Pain in
the lower limbs
Treatment of
Diabetic Ulcers
Early Management
and Preventive Measures
As soon as the ulcer is noticed, seek the help of a podiatrist
immediately. The physician helps identify the degree of severity of the problem
and helps to map the best course of action for each specific patient. If not
treated promptly, complications such as gangrene, cellulitis, and osteomyelitis
may ensue. If the ulcer is in an early stage, the doctor may suggest adopting the
following measures:
1.
Maintaining strict control of blood
sugar levels.
2.
Ensuring a healthy diet and proper
exercise.
3.
Cleaning the ulcer each day by using
aseptic measures.
4.
Keeping the feet dry after every
wash and use proper dressings.
5.
Wear loose-fitting shoes such as diabetic
offloading shoes which prevent excessive pressure on the heel and ball of
the big toe.
6.
If specific diabetic shoes are not available,
then inserts can be used as well which dissipate excessive
pressure from the contact points of the feet. There are hole cutouts in the
inserts which cushion the points of contact and prevent their ischemia.
7.
Wearing padded socks to provide
protection and cushion from injuries.
8.
Trimming the toenails while taking
care not to injure the edges of the toes.
9.
Checking inside of shoes to make
sure no objects are left inside.
10.
Protecting the feet from heat and
cold.
11.
Proper follow-up every 2 or 3 months
for monitoring the health of the feet.
12.
Cessation of smoking/alcoholism to prevent
further complications.
Surgical
Treatment:
If the diabetic ulcers become chronic or the alignment of the bones
becomes poor due to excessive damage then there is no choice but to intervene
surgically. Following are the methods employed in this modality:
a. Debridement:
In this procedure, the dead or infected tissue is entirely removed from
an ulcer. After the debridement, the wound is washed with disinfectants and is
covered with aseptic bandages. The wound then heals with time and the patient
is counseled to change bandages regularly.
b. Surgical
Revascularization: If poor blood flow is restricting
the full recovery of a diabetic wound, vascular surgery may be attempted to boost
the vascular perfusion. Atherectomy is carried out in which clogged arteries
are cleared by removing the plaque inside them. Balloon angioplasty may also be
done with stent placement to keep the vessels open. Both these methods help
increase the oxygen flow to the affected limb and boost the wound healing
capability of the ulcer.
c. Amputation: When an ulcer cannot be healed and is being repeatedly infected, it
may lead to gangrene which increases the risk of mortality. To avoid a fatal
outcome, amputation is the best treatment in such cases. Doppler studies of the
affected limb are performed to locate the ideal site for amputation which helps
prevent any recurrence.
Complications
of Diabetic Foot
If proper
management is not considered, then the following complications can develop:
1.
Abscess: A pocket of pus may form in the wound which can only be treated by
drainage.
2.
Deformities: Nerve damage weakens the muscles and may lead to claw feet or a the high arch which causes difficulty in walking.
3.
Charcot Foot and Deformities: It is due to walking on broken bones which eventually alters the contour
of the foot.
4.
Gangrene and skin infections:
Infected ulcers can lead to sepsis which is best treated with antibiotics.
Severe cases often require hospital admission.
New insert provided the necessary padding.
Great price and comfortable
Easy to work with. Great to use for a leg cast or any cast. It is really strong and looks great.
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