Diabetes and Wounds: Caring for Sores
Avoid amputation with the prevention and early treatment of skin sores.
5 Tips for Preventing Foot Sores continued...
Use an antifungal cream if you have evidence
of athlete's foot (tinea pedis) or other fungal infection. Athlete's foot can
make the skin crack and peel, which increases your risk for an infection. Be on
the lookout for fungal nail infections, too (nails will look and feel harder,
darker, and thicker). See your podiatrist or your doctor about treatment and
- Avoid fancy footwear. This means no tight socks and, above
all, no tight, pointy shoes with high heels.
"Footwear is probably one of the biggest
offenders," says Jeffrey Buehrer, MD, a vascular surgeon and wound care
specialist at Firelands Regional Medical Center in Sandusky, Ohio. A
well-fitted pair of athletic shoes is often a safe bet, or your podiatrist can
work with you to have shoes custom-fitted for your needs -- often at no charge
through the Medicare therapeutic shoe program. Brem admits that these shoes may
not be the most stylish, "But they will likely save your limb."
Diabetes and Wounds: Getting Timely Treatment
What if, despite your best efforts, you develop a foot sore? "Any break
in the skin of the foot is an absolute emergency," declares Brem.
"There's no such thing as 'just a little cut.'" Brem's
- Put a triple antibiotic cream on the foot sore immediately
- Cover the wound with a light gauze and keep pressure off the area
- See a local wound center within seven days at most
And calluses, which are precursors to foot ulcers in many diabetic patients,
should be considered -- and treated -- just as seriously.
"Diabetic foot wounds can develop complications rapidly," explains
Buehrer. "I'll see patients who tell me that they scratched their foot in
the garden and everything seemed fine, and then they woke up two days later to
find it horribly swollen. Early intervention is always better."
Once you go in to see the doctor about your foot sore, he or she may do
- Test that you have a good blood circulation to the area. This is called an
ankle brachial index.
If the ankle brachial index is 0.9 or less,
you should see a vascular surgeon to determine if intervention is necessary.
"An ankle brachial index of 0.9 or below could point to a 50% occlusion of
a major artery."
- Cleaning a foot sore is a process known as debridement. The doctor can
culture the area to check the type of bacteria that may be present.
"Looks can be extremely deceiving in a
person who has diabetes and a foot ulcer," Brem says.
- Offload your foot. This means putting it in a special custom-designed
support boot -- such as the Cam Walker or Air Calf Boot. "This may be
bulky, but it's absolutely necessary until you heal," says Brem. "If
everyone did these steps, amputations would decrease by 90%."