Monday, Sep 16, 2019
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Living with a wound that just won’t heal can be frustrating, scary and potentially serious

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, and what you can do to help prevent and treat them.

Ulcers can be acute – heal quickly – or chronic – heal slowly or not at all. There are several types of chronic wounds that may take a long time to heal. The most common types 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 reduced sensation to your feet; you have diabetes; or 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. Although foot ulcers can be serious, they usually respond well to treatment. Having an ulcer can also increase the risk of an infection in the ulcer, which can sometimes lead to more serious problems such as gangrene and even amputation.

Arterial and venous ulcers occur because the blood vessels are not working well. With arterial ulcers, there is not enough blood flow to the feet which leads 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 which causes 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.

What to do if you develop a foot ulcer

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. Do not leave the wound open, it slows wound healing. The ulcer should be covered with a protective dressing.

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, it may be protected 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 matter from the foot.

Persons with venous ulcers 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.

Nutrition and wound healing

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 counseling. It is important for a person 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 on your feet or legs, you should visit 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 foothealth242@hotmail.com; or visit www.apma.org.  

 

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