Patients with diabetes are prone to the development of foot ulcers. After years of elevated blood sugar, both nerves and small blood vessels in the feet are damaged. Patients therefore do not feel small injuries occur, and damage to the circulation predisposes people to the development of wounds that may not heal. Diabetes also affects the immune system, leading to an increase chance of infection of foot ulcers.
Ulcers can form on the feet of people with diabetes, usually after an injury or in places that receive constant pressure, such as the ball of the foot. Further testing can be done to assess the circulation of the foot, and to determine the extent of the loss of sensation.
Topical medications can be applied to encourage wound healing. We also use skin substitutes to heal acute and chronic wounds within 4-8 weeks. Surgically, skin plasty or skin grafts are used to close difficult wounds as well.
Diabetic ulcers may become deep or infected. In cases of bone infection, long courses of intravenous antibiotics may be required. In some cases amputation of the affected toe may be necessary.