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HealthInfo West Coast-Te Tai Poutini

Foot ulcers

Important

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

Also seek help if you've been diagnosed with a foot ulcer, and you have a patch of skin around your ulcer that's red, warm, and seems to be getting bigger. These could be signs of an infection (cellulitis). See your general practice team or after-hours healthcare service as soon as possible.

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

Foot ulcers can easily get infected.

How do foot ulcers occur?

You can get foot ulcers for many reasons but they're often caused by serious conditions such as diabetes, peripheral vascular disease or rheumatoid arthritis.

Poorly fitting footwear can cause foot ulcers.

Ulcers can also be caused by an injury like stubbing your toe or burning your skin on a hot surface – anything that can result in your skin breaking open.

Foot ulcers can often be hidden under a thick layer of discoloured callus. Go to see your GP or podiatrist if you notice a callus on your foot.

If I have diabetes, am I more likely to develop ulcers?

Yes. Diabetes can cause muscle and nerve damage in your feet, which can change the shape of your feet. This can cause foot deformities, such as bunions or hammertoes. Your footwear can rub the skin on these deformities, making it break open.

Also, if you have diabetes you may have little or no feeling in your feet. This loss of sensation, caused by the nerve damage from diabetes, means it may be harder for you to tell when your footwear is rubbing.

With diabetes, you may have a reduced blood supply (peripheral vascular disease) going to your feet and the site of the ulcer. This means the wounds will take longer to heal.

Your risk of developing ulcers is even higher if you've previously had a foot ulcer, or if you also have other diabetes complications, such as eye problems or kidney problems.

How can I heal my ulcer?

If you have diabetes and a foot ulcer, you're likely to qualify for publicly funded care from a podiatrist (you won't have to pay). Or you can pay to see one. Otherwise, your GP and practice nurse can help you manage your foot ulcer.

Talk to your health professional about assessing your feet and developing a plan for treating them. They may refer you to a specialist to speed up the healing process. This could be a vascular surgeon, orthopaedic surgeon, orthotist, infection expert, diabetes specialist nurse, or dietitian.

If you have diabetes, it's very important that you keep your diabetes under as much control as possible while you're being treated. This will affect how well your ulcer heals and reduce the risk of infection. Keeping your diabetes under control includes closely monitoring your blood sugar levels and eating well. You should also practise good foot care. See the advice on keeping your feet healthy in Diabetes & high-risk feet.

If you're concerned, talk to your GP, practice nurse or podiatrist about seeing a diabetes nurse specialist to help you manage your diabetes.

Also see How can I help my wound to heal?

How are foot ulcers treated?

Your podiatrist or practice nurse will remove any hard, dead or infected skin that's stopping the ulcer from healing. They'll apply dressings and, if needed, a temporary pad to help keep pressure off your wound while it heals. They'll give you advice about footwear and ways to keep pressure off your ulcer.

They'll also tell you how to keep the dressings clean and dry, and arrange follow-up appointments. They may arrange for a nurse to change your dressings or advise you how to change them yourself.

What happens after treatment?

It's essential that you follow your health professional's instructions. This will help your ulcer to heal as quickly as possible and minimise complications. In follow-up appointments, your health professional will keep monitoring your ulcer and recommend changes to your treatment based on how your wound is healing.

Make sure you go to all follow-up appointments and contact your health professional if you have any concerns about your treatment.

If you have diabetes, talk to your GP or practice nurse for advice and monitoring to help manage your diabetes and circulation problems as well as possible. Keeping your diabetes under control will reduce your chances of getting another foot ulcer.

Who do I contact for help?

Contact your GP or podiatrist. If you have diabetes and you're not sure how to contact your podiatrist, ask your general practice for details.

After hours, phone your normal GP phone number any time, day or night. A nurse will be able to give you advice about where you should go to get the medical care that you need.

Information provided by the Canterbury DHB. Adapted by the West Coast DHB. Page created October 2017.

Sources

Page reference: 441101

Review key: HIDIF-84656