Diabetic Ulcers

What is a Diabetic Foot Ulcer?
A foot ulcer is an open sore or wound that occurs on the foot. Approximately 15 percent of patients with diabetes will develop a foot ulcer and it is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 3 in 50 will be hospitalized due to infection or other complications. Diabetes is the leading cause of lower extremity amputations (excluding those due to trauma) in the United States. Foot ulceration precedes 85% of diabetes-related foot amputations. Research has shown, however, that development of a foot ulcer is preventable. Not only this put there are exciting new treatment options that can resolve ulcerations to prevent amputation altogether.


Causes
Anyone can develop a foot ulcer. Diabetic Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. Those who are on insulin, overweight, or alcohol and tobacco users further increase their chances of having a foot ulcer. Keep in mind that diabetes is not the only cause of foot ulceration, they can also be due to things such as peripheral vascular disease, weakened immune systems, and other systemic diseases. Ulcers usually form from one or a combination of factors: poor circulation, neuropathy, or excessive amounts of pressure. In diabetics with elevated blood glucose levels these ulcers can develop without the patient even feeling them. Your doctor can check for all of these risk factors in a 30 minute office visit.

Diagnosis and Treatment
The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance of infection and amputation There are several key factors in the appropriate treatment of a foot ulcer:

  • Treatment and prevention of infection
  • Reducing pressure on the area, or "off-loading"
  • Removing dead/ devitalized tissue, or "debridement"
  • Managing blood sugar levels and other health problems
  • Applying special dressings to the ulcer, such as stem cells
The cutting edge course of treatment involves stem cells and growth factors. These two wound healing powerhouses have been shown to have a dramatic impact on wound healing. That makes sense, since these are the very cells that are directly responsible for tissue healing and repair yet also inhibiting infections. Synthetic skin grafts have been shown to lead to 62% complete wound closure compared to 21% with standard wound care (offloading, debridement, antibiotics). In a recent study, wound closure time was also noted to be an average of 42 days vs 69.5 days without synthetic/ stem cell grafting. The treatment is painless and takes roughly 15 minutes in the office. It is FDA and Medicare approved, however most insurance companies allow it for both Diabetic and non-diabetic wounds as well. Through our extensive training we have devised multiple ways to treat complex/ chronic wounds. If you have a wound that won’t go away let CPS get you the closure you need.

More information
You can also download our Podiatry-at-a-Glance newsletters: A Guide to Diabetic Foot Care and Ulcerations.