Foot, Ankle, Heel, Leg Ulcerations due to Diabetes, Arterial Disease or Venous Insufficiency

 

Information from your Podiatrist in Orange County

 

Many diabetic patients eventually develop foot ulcers. These wounds are the principal portal of entry for infection in patients with diabetes. The ulcers are usually covered by callus or fibrotic tissue. This makes the trimming of hyperkeratotic tissue important for comprehensive wound evaluation.

These ulcers are typically painless.

Adequate debridement is the first step in the evaluation of a foot ulcer.

After debridement, the ulcer should be probed with a sterile blunt instrument to determine the involvement of underlying structures, such as tendon, joint capsule or bone.

X-ray should be obtained to look for soft tissue gas and foreign bodies and to evaluate the ulcer for bone involvement.

The involvement of underlying structures and the presence or absence of ischemia and/or infection must be determined before an appropriate wound classification can be made and a subsequent treatment plan can be implemented.

Recognition of risk factors, preventive foot maintenance and regular foot examinations are essential in preventing foot ulcers in patients with diabetes.

Prevention

 

Meticulous attention to foot care and proper management of minor foot injuries are key.
Daily foot inspection by the patient or caretaker.

Gentle cleansing with soap and water, followed by the application of topical moisturizers. Avoid application of moisturizers in between the toes

Custom shoes and insoles to offload and pad the foot.

Medicare covers the cost of custom shoes and insoles for patients that qualify.

Avoid hot soaks, heating pads and harsh topical agents.

If arterial disease is present than a consult to a Vascular Surgeon is very important.

A great way to prevent Venous ulcerations is via compression therapy (compression stockings).