Manufacturers

Pressure Ulcers

Wound Care Suggestions

Note: Ulcer care should always be done in conjunction with your physician. All products should be used as directed on the package insert.

• Diabetic ulcers of the skin are caused when the skin looses sensitivity or when the skin circulation is impaired (ischemia).
• Ischemia causing diabetic ulcers occurs when the small vessels (microvascularature) in the skin becomes occluded and the circulation is slowed.
• Loss of sensitivity, called peripheral neuropathy, can lead to cuts or wounds that the patient does not feel when they occur. There is no cure for this loss of sensitivity although good glucose control can prevent it from progressing.
• This loss of sensitivity particularly on the feet can cause ulcerations called plantar ulcers. Infection of the underlying bone (osteomyelitis) beneath an ulcer can eventually lead to lower limb amputation.

• Prevention: Prevention is more important than treatment. The following preventative measures can be done.

• Close control of blood glucose level.
• Maintain proper body weight.
• Avoid smoking which makes small vessel disease worse.
• Foot inspection should be performed daily by the patient and when you see the doctor.
• Wear comfortable well-fitting shoes; avoid footwear that is too tight or inflexible.
• Proper hygiene with regular washing and thorough drying of the feet should be encouraged
• Neurological examination should include a sensory motor exam to determine whether protective sensation is intact or lost.
• Nails should be kept trimmed; cutting them too short should be avoided.
• Thickening of the nails may indicate ischemia or a fungal infection.
• Treatment: If an ulcer has already developed:
• See your physician:
• Debridement (surgical removal of dead tissue) maybe needed. Keep the wound moist and covered with the appropriate wound dressing.
• Avoid weight bearing on an foot ulcer. Weight bearing relief can come from the use of contact casts, shoe inserts, special shoes, and even crutches.
• Referral to a specialist in foot shoes may be recommended by your physician.
• Bed rest or foot elevation during the day may be required to keep pressure off the foot, heels, ankles and toes.
• Not taking a diabetic ulcer seriously early may lead to amputation later.