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What is Involved in the Treatment of Diabetic Foot Ulcers?

By T. Broderick
Updated May 17, 2024
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Treatment of diabetic foot ulcers begins with a physician determining the cause. The physician then closely examines the ulcer, noting its location on the foot, size and possible presence of infection. Treatment of diabetic foot ulcers depends wholly on what a physician determines from his or her examination. Possibilities range from close monitoring of the ulcer and a prescription of antibiotics to surgery or amputation of the foot. No matter the form of treatment a patient receives, it becomes the patient's responsibility upon returning home to monitor the ulcer, rest and immediately consult a physician if further tissue damage should occur.

The first step in the treatment of diabetic foot ulcers is determining why the ulcer developed. This step is important, as a patient's remarks can indicate an underlying problem. Though individuals with diabetes are more prone than the general population to develop foot ulcers, the appearance of an ulcer without a physical cause such as increased walking or long periods of standing suggests to a physician that the patient is mismanaging his or her diabetes. These suspicions are easily confirmed through blood glucose level tests. High blood glucose levels indicate that an ulcer developed due to a combination of arterial hardening and neuropathy within the foot.

Whether the cause was physical injury or diabetes mismanagement, treatment of diabetic foot ulcers depends on the results of a physical examination. The width and depth of the ulcer are especially important, as a deep ulcer can expose fatty tissue and muscle. Patients with large ulcers should expect more invasive treatment and longer recovery times. During an examination, physicians also search for signs of an infection. He or she might take a swab of the ulcer to test for the presence of viral, fungal or bacterial infection.

If tests show the presence of an infection, a physician prescribes medication to the patient as he or she begins to treat the ulcer. Smaller ulcers require only a cleaning and bandaging. A physician may pack gauze into the ulcer cavity; he or she will remove it during a follow-up visit. Slightly larger ulcers may require minor surgery to removed diseased or dead tissue. A patient should expect brief hospitalization so a physician can monitor the immediate healing process.

Treatment of diabetic foot ulcers becomes complicated when a patient presents with multiple ulcers that are large and deep. These ulcers require more extensive surgery. The patient's diabetes also extends the recovery period, increasing the chances of post-operative complications such as infection. Amputation of toes and the foot itself becomes necessary when ulcers cause extensive neuropathy and arterial damage. In these cases amputation is advantageous, as the patient can more quickly resume a normal life.

Though many forms of treatment exist, responsibility for post-operative care is mainly the patient's. Upon returning home, the patient becomes responsible for changing bandages and, if necessary, continuing to take medication to fight the ulcer's infection. If the ulcer formed due to diabetes mismanagement, lifestyle changes are required to prevent future ulcers and other complications from diabetes. Even if a patient follows the instructions of his or her physician, complications are still common. A patient must seek medical attention if the same or a new ulcer reappears.

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Discussion Comments
By Rotergirl — On Nov 26, 2014

@Pippinwhite -- Preach it! That is so true. Prevention and early treatment are key.

My dad had a diabetic ulcer on his foot, but he went to get it treated, and even though it never healed completely, it stayed under control because he kept a dressing on it and saw his doctor regularly to have it trimmed and cleaned.

One extremely gross-sounding remedy is the maggot bandage. Since maggots do not eat healthy flesh, a bandage saturated with them will get rid of the bad skin naturally, leaving healthy, clean skin. It's a bizarre-sounding treatment, but I've seen over and over again that it works very well.

By Pippinwhite — On Nov 25, 2014

The best way to treat ulcers is to either keep them from forming in the first place, or to treat them *immediately.* You can't let them go. Go ahead and go to the doctor or urgent care, and get the ulcer taken care of before it gets away from you. Getting the ulcer treated while it's still the size of a pin or a pencil eraser is ideal. Do that, and you have a good shot and getting rid of it before it advances too far.

Of course, this means the diabetic *has* to keep an eye on his feet -- and on his blood sugar. That will do more than any doctor can to keep the feet healthy and ulcer-free.

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