Diabetic Foot ulcers
The diabetic patient and his family should be informed about correct implementation of measures designed to decrease the risk of diabetic foot ulcers (DFU) and associated complications.
Two to ten percent of diabetics have foot ulcers. The risk of developing a diabetic foot ulcer increases with the duration of the diabetes. Unfortunately, the majority of foot and lower leg amputations are performed in patients with diabetes mellitus. The top priority in treating the diabetic foot syndrome is to avoid ulceration and amputation.
Practical advice for patients and patient’s family
Adapt your lifestyle to prevent DFU:
- Maintain an appropriate blood glucose control
- Maintain blood pressure control
- Lipid management
- Smoking cessation
- Physical activity is highly recommended: You should walk every day
Tips concerning nail and skin care to prevent DFU:
- Wear wide, comfortable and cushioned shoes to avoid internal friction
- Wear seamless cotton socks
- Wash feet daily with warm/cold water and an acidic soap
- Inspect the feet daily for early signs of lesions (heels, plantar and interdigital zones)
- Carefully dry by blotting or patting (avoid friction)
- In case of dry skin, calluses, and skin cracks: apply emollient/hydrating creams
- Calluses should ideally be treated by a podiatrist, avoiding the use of keratolytic solutions
- Nails should be cut straight – better to use a nail file
- Never walk barefoot on any kind of surface
- Avoid use of hot packs or electric warmers to prevent risk of burns
Treatment of Diabetic foot ulcer:
The treatment of diabetic foot ulcers is aimed at preventing infections and providing an optimal wound healing environment. If a diabetic foot ulcer is suspected, an urgent referral and assessment is vital as a delay in diagnosis and treatment increases morbidity and mortality and can contribute to a higher amputation rate.
Important factors in the care of patients with diabetes 4 are:
- Vascular control of the disease (e.g. regulation of serum glucose levels and arterial risk factors such as hypertension and dyslipidemia)
- Pressure offloading
- Debridement of the DFU
- Treatment of infection: patients with infected wounds require an early treatment with systemic antibiotics 4
- Effective use of wound dressings
Once the DFU has healed, it is important to prevent recurrence or development of a new DFU.
