Foot Wounds Are Dangerous
Feet and ankles are particularly vulnerable to diabetic wound problems, according to Cohen. "Wound healing below the knee is a different dynamic than in other parts of the body," he says. "These areas are prone to swelling, which can inhibit healing. Also, if you have a wound on your arm, you can immobilize it. This is much harder with a foot wound."
But it's not easy for people with diabetes to avoid foot wounds because they are more likely than other people to have calluses, dry skin and nerve damage. All of these combined can lead to an increased risk of ulcers (open sores) and can lead to infections. Along with loss of feeling in their feet, many people with diabetes also have vision problems. So they may neither feel nor see a small wound until it becomes serious, says Snyder.
A wound that becomes serious may do more than cause pain and inconvenience. It may cause so much damage to tissue and bone that amputation becomes the only option.
Research shows that an ulcer precedes most lower limb amputations in people with diabetes. That's why it's so important to care for a wound before it becomes serious -- or, if at all possible, prevent wounds in the first place.
How to Prevent Wounds
The best way to avoid wound problems is to prevent wounds in the first place:
- Check your feet daily. Look for blisters, calluses, chafing, and redness. "This is the single most important thing you can do to avoid diabetic foot problems," says Cohen. If you have trouble seeing, have someone else check your feet every day.
- Pay attention to your skin. Check for small, seemingly minor skin problems like infected hair follicles or inflamed areas around the fingernails. If you notice a problem, speak with your doctor.
- Moisturize your feet. Use moisturizer to keep the skin on your feet soft and supple. But don't use lotions between your toes because this can lead to an fungal infection. To treat athlete's foot, Cohen recommends using a gel rather than a cream antifungal product because gels don't leave a moisture residue between the toes.
- Wear proper footwear. Wearing well-fitting shoes can help you avoid blisters. Closed-toe shoes reduce the risk of foot injury. "We advise our patients to wear close-toed shoes, even around the house, " says Cohen. If you have trouble finding shoes that fit properly, speak to your doctor. You may need a custom-made shoe.
- Inspect your shoes every day. People with diabetic neuropathy may walk around with a pebble or other object in their shoe without knowing it is there, says Snyder. You should also check for tears or rough areas on the inside of the shoe.
- Choose the right socks. Buy socks that wick moisture away from skin. Avoid socks with seams. Socks made specifically for people with diabetes are available in many specialty stores and online.
- Wash your feet daily. After washing, dry them carefully, including between the toes.
- Smooth away calluses. After your bath or shower, use an emery board or pumice stone to gradually remove calluses. Never cut calluses with scissors or a nail clipper.
- Keep toenails clipped and even. Ingrown toenails can lead to foot problems. Have your doctor check your feet regularly.
- Manage your diabetes. Preventing serious foot wounds also means keeping your diabetes under control. This includes monitoring blood sugar, blood pressure, and cholesterol levels; eating healthfully; taking the medications your doctor prescribes; exercising regularly; not smoking; and having regular medical checkups.
Snyder emphasizes the importance of consistent preventive care for people with diabetes. "If you have diabetes, you should have a team of specialists who you see for regular medical checkups, including a podiatrist and an ophthalmologist, as well as your primary care doctor," he says.