Prevention and Treatment of Foot Ulcers
The single most important way to prevent foot ulcers if you have diabetes is to control your blood sugar levels. High blood sugar creates the conditions—nerve and/or blood vessel damage--that can lead to ulceration. Other preventive steps include the following:
• Inspect your feet and legs daily. Look and feel for:
o Bumps, lumps, blisters or bruises;
o Cuts, sores, or cracked skin;
o Patches of thin or shiny skin (which can signal reduced blood flow) or areas of redness (especially red streaks, which can signal the presence of infection);
o Temperature differences (one part warm, another cold). This can signal lack of blood flow;
o Pain, tingling, numbness or no feeling at all. These can signal nerve problems;
o Ingrown toenails with red, puffy skin along the nail and tenderness or pain;
o Loss of hair on foot or leg, which can be a sign of reduced blood flow .
• IPFH suggests wearing only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically-tested padded socks can help protect against injuries to the skin/soft tissue of the foot, a major cause of diabetic ulcerations.
• See a foot care professional for regular foot examinations and preventive foot care.
In addition, IPFH suggests taking the following preventive steps:
• Check inside shoes daily for sharp points, sharp edges, seams or other rough areas or foreign objects that may lead to cuts, wounds or abrasions on your feet.
• If you have numbness, tingling or loss of feeling in your feet, be extra cautious. Make sure there are no sharp objects such as broken glass, nails, or exposed sharp edges on floors or in carpeting. Never walk or move around barefoot, even inside your house.
• Wash feet daily using lukewarm (never hot) water and mild soap. Use your elbow to test water temperature. After washing, dry feet thoroughly and keep them supple by applying lotion to the tops and bottoms of your feet. Do not attempt to cut toenails if you have neuropathy or other foot problems related to diabetes. See a podiatrist or other foot health professional regularly for toenail care and foot examinations. Never attempt to cut or file calluses or other protrusions on your feet.
• Never use wart removers or other harsh chemicals on your feet.
• Don’t cross your legs for extended periods, as this can reduce blood flow and create pressure points. For the same reason, don’t sit for more than an hour or two without changing positions.
• Walk as much as possible; doing so enhances circulation to the feet and helps with weight and blood sugar control.
If you have not been diagnosed with diabetes or other systemic issues or diseases, you should still inspect your feet daily, especially if your job requires you to spend extended time on your feet or you participate in recreational activities in which you spend time on your feet. As noted above, IPFH suggests that you follow an integrated approach in the selection of your padded socks and footwear.