Print this topic

HealthInfo Canterbury

Diabetic foot ulcers

Important!

If you have diabetes and think you could have a foot ulcer, contact your GP, practice nurse, or podiatrist immediately.

A foot ulcer is a break in the skin. It can be quite shallow and only involve the very top layer of skin (a superficial ulcer) or involve deeper skin layers (full thickness ulcer). In some circumstances, if the ulcer becomes too deep, it may reach the bone, tendons and other parts of the foot.

How do foot ulcers occur?

If you have diabetes, your ulcers will mainly be caused by poorly fitting footwear. These can rub over the skin, causing it to break open. This is more common over time, as the shape of the foot changes. This results in prominent features, such as bunions or hammertoes, forming and rubbing in your footwear.

However, ulcers can also be caused by direct injury like stubbing your toe or burning your skin on a hot surface – anything that can result in the skin breaking open.

If I'm diabetic, am I more likely to develop ulcers?

Yes. If you have diabetes you may have little or no feeling in your feet. This loss of sensation, caused by nerve damage from diabetes, means it may be harder for you to tell when your footwear is rubbing. Also, if you are diabetic, you may have a reduced blood supply going to your feet and the site of their ulcer. This means the wounds will take longer to heal.

How can I heal my ulcer?

Talk to your diabetes podiatrist about having your feet assessed and developing a tailored management plan that you are both happy with. As a result of the assessment, they may refer you to a specialist to fast track the healing process. This could be a vascular surgeon, orthopaedic surgeon, orthotist, infection expert, diabetes specialist nurse, or a dietitian.

While treatment is being organised and delivered it is very important that you try to keep your diabetes under as much control as possible, as this will have a big influence on how well the ulcer heals and reducing the risk of infection. If you're concerned, talk to your diabetes podiatrist about seeing a diabetes nurse specialist to help you manage your diabetes.

See also How can I help my wound to heal?

How are foot ulcers treated?

Your podiatrist first applies appropriate dressings and, if needed, a temporary pad to help remove pressure off the wound while it heals. Afterwards, they give you advice about footwear and ways to keep pressure off the ulcer, and how to keep the dressings dry and clean, before arranging follow-up appointments. They may also arrange for a nurse to continue applying your dressings or, if you agree, advise you how to apply the dressings yourself.

What happens after treatment?

It is essential that you make all attempts to follow your diabetes podiatrist's instructions. This is to minimise complications and speed up the healing of your ulcer as much as possible. In follow-up appointments, your diabetes podiatrist will continue to monitor your condition and recommend changes to treatment based on how your wound is healing.

Make sure you attend all follow-up appointments booked with your diabetes podiatrist and contact them if you have any concerns about your treatment.

Who do I contact for help?

If it is an emergency and you're unable to contact your diabetes podiatrist, phone the 24 Hour Surgery on (03) 365-7777. If you're unsure how to contact your diabetes podiatrist, phone the Diabetes Centre (located at 550 Hagley Avenue) on (03) 364-0860.

If it's not an emergency, contact your GP or the podiatrist they referred you to the last time you discussed the issue.

Written by HealthInfo clinical advisers. September 2016.

Source

Page reference: 306237

Review key: HIDIF-84656