June is Wound Healing Awareness Month. Wounds are sores or cuts in the skin also known as ulcers. Living with a wound that just won’t heal can be frustrating, scary and, potentially, serious. A foot ulcer can be prone to infection, which may become severe and lead to amputations. Seeing a wound specialist will help speed up healing and improve your quality of life.
There are different types of wounds based on the cause and location of the wound on the body. Let’s look at why foot ulcers sometimes develop, what you can do to help prevent and treat them.
Ulcers can be acute – heal quickly or chronic meaning they take a long time to heal or do not heal. There are several types of chronic wounds that may take a long time to heal. The most common types include:
The most common types of problem wounds include diabetic foot ulcers, arterial ulcers due to poor blood flow to the feet, pressure ulcers, venous ulcers, traumatic wounds, and non-healing surgical wounds.
Foot and leg ulcers occur for several reasons. They are more common if you have diabetes, if you have reduced sensation to your feet, if your diabetes is not controlled, and if you have poor blood flow to the feet you risk developing a diabetic foot ulcer. The risk of this occurring increases the longer you have diabetes and the older you are.
Arterial and venous ulcers happen because the blood vessels are not working well. With arterial ulcers there is not enough blood flow to the feet leading to ischemia, pain and gangrene while venous ulcers result from malfunctioning veins. Pressure ulcers also called “bed sores” are caused by constant pressure on the skin that cause them to break down. Traumatic wounds and non-healing surgical wounds are self-explanatory and usually don’t last as long as the other chronic wounds.
Although foot ulcers can be serious, they usually respond well to treatment. However, foot ulcers can become worse and can take a long time to heal if you have diabetes, particularly if your circulation is not so good. Having an ulcer can also increase the risk of an infection in the ulcer. Sometimes it can lead to more serious problems such as gangrene and even amputation.
If you have an ulcer or sore on your feet or lower leg see your podiatrist or primary doctor as soon as possible. They will examine your feet and treat the ulcer and aim to dress and protect the ulcer, to prevent or treat any infection and also to help your skin to heal. The ulcer should be covered with a protective dressing. Do not leave the wound open, it slows wound healing.
According to the type of ulcer, the podiatrist may need to remove any hard skin that prevents the diabetic foot ulcer from healing. Also, depending on the site and size of the ulcer, they may protect it from further injury by using padding to take the pressure off the area. You will also need to stay off your feet, wear special shoes or have a cast made for your foot to keep the pressure off the ulcer. If the ulcer is infected, antibiotics will be ordered. If there is an abscess, a small operation may be needed to drain pus or other drainage from the foot.
People with a venous ulcer will need to wear compression dressing or hoses to help treat the ulcer. If it is an arterial ulcer you will be sent to see the vascular doctor for them to check out your blood flow to the feet. Sometimes you may require an operation to open up the arteries. Pressure ulcers will need to be offloaded to take the pressure off the area and allow the ulcer to heal.
The podiatrist may order an X-ray or other imaging scans of your foot to make sure the bones have not been affected by the ulcer. Many foot ulcers will heal with treatment however, they may take a long time to heal. In some cases, without going to the doctor, the ulcer may worsen, become badly infected and may not heal. Sometimes infection can spread to nearby bones or joints, which can be difficult to clear, even with a long course of antibiotics. Occasionally, the tissue in parts of the foot may be at risk for an amputation.
Many people with wounds may be elderly, have diabetes, and be overweight or even obese. Besides having a skin ulcer caused by diabetes, bad veins, low blood flow or persistent pressure these persons often have unrecognized signs and symptoms of malnutrition. The doctor will check the health status of the person by asking questions about nutrition and their eating habits and check labs. They may also be referred to a nutritionist for a more complete assessment and counselling. It is important for people with wounds to eat a balanced diet with good quality protein, more veggies and fruits and less processed foods and sugar. Adequate protein and vitamins and minerals like vitamin C are needed for wound healing because they help repair and make new skin. If you have an ulcer or wound to your feet or legs, it’s time to see the podiatrist.
• For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820; or email email@example.com; or visit www.apma.org.