Take the first step in understanding foot ulcers and wound care

The number of Americans with diabetes, most commonly type 2 diabetes, is growing more than ever before, according to the Centers for Disease Control and Prevention. The percentage of those diagnosed increases with age, but other risk factors for developing diabetes include diet, activity level, smoking and obesity.

One complication of diabetes is a foot ulcer. Nearly 25% of diabetics will develop a foot ulcer during their lifetime. As many as 40% of people with a healed ulcer will develop a new one within a year. 

The development of a foot ulcer typically occurs in three stages:

• A callus forms as a result of neuropathy - damage to the nerves, causing pain and numbness.
• The skin dries out and becomes flakey as skin cells die.
• The callus progresses to a state of hemorrhage, then erodes to become an ulcer.

Patients with foot ulcers can also develop severe buildup of plaque, called atherosclerosis, of the small blood vessels in the legs and feet, leading to vascular complications. Because blood cannot reach the wound, healing is delayed which can lead to necrosis and gangrene.

Jennifer Steiner, RN and clinical program director for HSHS St. Elizabeth’s Hospital’s Wound Care Center, says ulcers most often develop on the ball of the foot or the bottom of the big toe.

“It can be really challenging treating these ulcers,” says Steiner. “Because of the numbness, oftentimes patients continue to walk on their wound, which causes extensive damage, leading to infection and the need for urgent medical care.”

If you are diagnosed with diabetes, taking care of your feet is very important, even if they feel fine.

• Wash your feet thorough every day
• Keep your toenails trimmed and filed with an emery board
• Check your feet daily for sores, cuts, blisters and/or redness; look between your toes
• Do not remove calluses or corns yourself
• Moisturize your feet, but avoid moisturizing between the toes
• Wear shoes that fit well; don’t walk around barefoot

Signs you may be developing a diabetic foot ulcer, include:

• A callus with bleeding beneath it
• A dark or bruised area of your foot
• Blister(s)
• Redness that does not go away

“If you have a foot ulcer, it is important to see a wound care specialist,” says Steiner. “We can provide several treatment options based on the severity of the ulcer – total contact casting, negative pressure wound therapy and hyperbaric oxygen treatment for example – which can be effective in providing healing.”

HSHS St. Elizabeth’s Wound Care Center, in partnership with Healogics, the nation’s largest provider of advanced wound care services, offers a comprehensive wound care program to manage chronic or non-healing wounds caused by diabetes, circulatory problems, and other conditions and specializes in advanced wound care, using a variety of clinical treatments, therapies and support services to treat chronic wounds.

Contact St. Elizabeth’s Wound Care Center to learn more about diabetic foot ulcers or if you have a chronic or infected wound that will not heal. For more information or to schedule an appointment or evaluation, call 618-234-2120. Patients may be seen with or without a physician's referral.

For more information about diabetes foot complications, visit the American Diabetes Association website.