People with diabetes are always at risk of diabetic foot ulcers, infections, and wounds because diabetes weakens the immune system and makes your body vulnerable to infections. If you get any wound on the foot, any bacterial infection can easily affect you. However, diabetes foot ulcers are treatable especially when you notice the wound early. Learn about treatment options for diabetes foot ulcers in this article. At Doral Health & Wellness, we have all the answers you need.

Treatment of diabetic foot ulcers

Diabetic foot ulcer treatment focuses on treating the wounds and preventing new ones.

Medications

Your doctor may prescribe medication based on the infection. It may include antibiotics, antiplatelets, or anticlotting medications to treat your ulcer if the infection progresses even after preventive or anti-pressure treatments.

Generally, antibiotics are enough to fight the infection and kill the bacteria. The duration you need to take the medication varies based on the severity of the infection.

In case the infection spreads to tissues or bone surrounding the wound, your doctor may recommend intravenous (IV) infusion antibiotics (given through a vein). This ensures antibiotic delivery directly into the bloodstream and helps the body fight infection more quickly.

Talk with your doctor to understand other health conditions that may increase the risk of infections such as HIV and liver problems.

Hyperbaric oxygen therapy

This therapy is prescribed to speed the healing of soft tissue damage caused by a foot ulcer. In this therapy, an individual has to lie on their back on a comfortable bed inside an enclosed, transparent chamber. The chamber is connected to a machine that fills the space with 100% oxygen. Breathing pure oxygen can increase the amount of oxygen in the bloodstream tenfold which significantly speeds up the healing of a foot ulcer by stimulating the growth factor and stem cells to repair damaged tissue.

For the best results, most people need multiple sessions of this therapy. Each session lasts for 2 hours, and you can relax during the sessions by watching TV or listening to music. Severe foot ulcers may take weeks or months to heal, even with this therapy. The best thing about this therapy is that it causes no side effects.

Surgical options

Your doctor may recommend surgery if all other ulcer treatment fails to heal the wound and to prevent the wound from getting worse or leading to amputation. Your doctor may suggest surgery if you have diabetes along with lower extremity arterial disease, a condition that reduces blood flow to the legs and feet. This prevents your foot from getting the required nutrients it needs for healing.

Besides, if you experience recurring or chronic ulcers in certain areas of the foot due to poor alignment, then surgery can improve the position of the bones in the foot. Poor alignment can occur when the bones of the foot are not in the line, resulting in uneven distribution of body weight across the foot.

The doctor may suggest any one of the following procedures depending on the wound requirement:

• Skin grafts: This procedure is used to reconstruct weakened or missing skin to promote healing and reduce the risk of infection. Skin is usually taken from other parts of the patient’s body such as the thigh or comes from a donor, depending on the individual.
• Vascular surgery: This surgery is used to restore proper blood flow to the wound site to promote healing and keep the skin healthy.
• Shaving or removing bone: This surgery is used to fix deformities that put pressure on the surrounding area such as hammertoes, bone spurs, and bunions.
• Reconstruction: This surgery is also used to fix deformities such as flat or high-arched feet that cause high pressure on the wound.
• Realigning or fusing joints: This surgery is used to address biomechanical defects that increase pressure.
• Lengthening tendons: This surgery is used to release tension and take pressure off an ulcer, allow it to heal, and prevent it from recurring.
• Amputation of a toe and the foot: If the tissue is severely damaged or an infection can’t be stopped from spreading, and all other treatments have failed to produce any results, then amputation of the toe and the foot is recommended.

Your doctor will talk with you about the benefits and risks involved with the surgery and what to expect before, during, and after the procedure. For a high success rate in surgery, doctors recommend making lifestyle changes to ensure you get the best recovery and reduce the risk of recurrence. Your care team will support you in your long-term health goals.

Wound care, debridement, and dressings

For wound care, the doctor will clean and disinfect the ulcer, and then, remove any dead tissue around it, this procedure is called debridement. During this procedure, a doctor uses a sharp tool like a scalpel to remove tissue from within and around the wound. Then, clean the wound with a disinfectant solution. This may need to be performed more than once over weeks or months to promote healing.

After the wound is cleaned, the doctor applies bandages to keep the area covered until it heals. Your doctor also guides you on how to clean and dress the wound at home and prescribes a topical antibacterial ointment to use for quick healing and stopping infection. If you feel discomfort or pain, the doctor may prescribe over-the-counter pain relief medication such as ibuprofen or acetaminophen.

To prevent the infection from spreading, your doctor may advise:

• Off-loading (means avoiding putting pressure on ulcers as much as you can) because it can make the infection worse and expand the ulcer. To protect your feet, you can wear specially designed shoes for diabetes, casts, foot braces, compression wraps, and shoe inserts.
• Disinfect the skin around the ulcer with antibacterial ointment regularly.
• Keep the ulcer dry by changing the dressing frequently.
• Use a dressing that contains calcium alginates because it helps to stop bacterial growth.
• Manage your blood pressure, and cholesterol levels, and quit smoking, if you do.

Your doctor may recommend using different kinds of dressings to treat your ulcer. Wet-to-dry dressings are mostly used first because when they dry, they absorb wound material. When the dressing is removed, some tissues may come with it. Your doctor will guide you on how often you should change your dressing and whether you can do your dressing on your own or if you need the assistance of another person. A visiting nurse may also help you.

Other types of dressing include – dressing that contain medicine or skin substitutes. Make sure your dressing and surrounding skin are dry and don’t let other healthy tissues around the wound get wet too much from your dressings. This can soften the healthy tissue and cause more foot problems.

Daily wound care is required until your wound is healed. Diabetic people and lower extremity arterial disease often heal slowly, so it may take weeks or months for a foot ulcer to recover fully. During the healing process, the doctor also suggests keeping your blood sugar levels in the targeted range for faster recovery.

Treating diabetic foot ulcers is not challenging if you notice a sore or wound in your foot and take early action to prevent the infections from increasing. Untreated infections may lead to amputations. Doctors treat your wounds and guide you on how you should do daily wound care and dressing to ensure that your wound is healed on time. For proper healing, the doctor may ask you to manage your blood sugar levels, blood pressure, and cholesterol levels in the target range and try to avoid putting pressure on the wound. Once your ulcer has healed, you need to follow consistent preventive care to ensure your ulcer doesn’t recur.

Need help with your diabetic wounds, visit our diabetologist in Brooklyn clinic for professional medical help. Call us on +13473845690 and get answers for all your queries. Log on to  www.doralhw.org or visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212 to book an appointment with our endocrinologist to get the best treatment. We have the best endocrinologists who treat these kinds of diseases and helpful staff to aid you during your treatment.