Types of Chronic Wounds Diabetic Foot Ulcers, Prevention & Care

A coordinated, multidisciplinary approach offers the best way to prevent and treat diabetic foot ulcers and their complications. This involves scheduling regular visits with medical doctors. Poorly controlled sugar levels can cause many complications such as heart disease, inadequate blood flow, and kidney disease. Ask your diabetologist or primary doctor about an ACE inhibitor, which may lower the risk of stroke or halt renal failure; and a 24-hour insulin pump for better control of diabetes—even if you have Type 2. The use of Lantus®, which is a single, daily insulin dose, has been very helpful to patients for control of diabetes.

Orthopedic foot surgeons and podiatrists are critical members of the wound team. They can help people with diabetes manage nail and foot care. Fungal infections affect many people with diabetes, and management of these infections is complicated by diabetes—related medical factors that impair healing. Proper nail care is essential, as toe nails can puncture the skin, creating an ulcer which becomes a pathway for bacteria to enter the body.

A vascular surgeon can treat people with diabetes who have ischemia (inadequate blood flow to the tissue). Diabetic ischemia increases the risk of amputation. Surgical revascularization, which increases the blood flow to the affected tissue, is of foremost importance in healing wounds and saving limbs.

An ophthalmologist should be seen at least once a year for a complete eye exam. Cataracts, vision impairment, and even blindness are all possible complications of diabetes.

A cardiologist can test for heart disease, a serious complication for persons with diabetes. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.

A neurologist should be consulted if a loss of sensation is noted. One of the most common complications of diabetes is diabetic neuropathy (nerve damage) which results in a loss of sensation and feeling.

A nephrologist (kidney specialist) is brought in if creatinine levels are elevated. Creatinine is a measure of kidney function.

In addition, people with diabetes can help care for themselves by not smoking. Smoking reduces the rate of oxygen intake and delivery to the wound site and slows healing. The nicotine, carbon monoxide, and hydrogen cyanide in smoke have a toxic effect on platelets and inhibit normal cellular metabolism, which also impairs healing.

People with diabetes should perform regular self-examinations for indications of breaks in the skin. Any breaks that are found should be examined immediately by the wound doctor.