May Be Prelude to Serious Condition
Sometimes it is only a minor accident; you may not even notice that you’ve developed a sore on your foot. This is especially true of patients with peripheral neuropathy (nerve disease) who are not able to feel pain or irritation. At our clinics in DeSoto, Dallas and Sunnyvale, we treat patients who are not aware that they have a potentially serious wound on one of their feet. Unfortunately, an ulcer can be a prelude in some cases to infection, gangrene and eventually, amputation.
An ulcer starts with irritation. It may be caused by ill-fitting shoes. At first, the patient might notice a red sore on the surface of the skin that fails to heal. Deeper foot ulcers can extend beneath the skin and may eventually affect tendons or bones.
Patients with diabetes who have compromised nervous systems or poor circulation are at high risk of foot ulcers. Ulcers are especially troublesome for patients who have some malfunction of the vascular system (blood circulation), as this may inhibit healing.
We begin our evaluation by examining the size, location, depth and shape of the wound. We also ask about your ability to feel pain and irritation in that area of the foot.
We are especially concerned about possible infection of the ulcer, which is why we check for
- cellulitis (bacterial infection)
- odor that could indicate an infection
- fluid draining from the wound
Signs of Infection Raise Warning Flags
Any of these warning signs should prompt a visit to your doctor as soon as possible.The doctor is concerned with combatting infection and preventing further developments such as gangrene, which presents itself as the presence of dead or decaying tissue.
Treatment can be performed in our clinic. Debridement, for instance, consists of removing all dead tissue, bacteria and foreign bodies from the wound. Debridement is necessary to allow the wound to drain, reduce risk of infection and speed healing. We then apply medication and dress the wound to protect the skin from contamination.
Good foot care begins at home. Diabetic patients are generally advised to examine their feet daily. For some patients with diabetes, a foot ulcer can be the beginning of a chain reaction: an ulcer develops into an abscess, (a pocket of pus); infection spreads across and under the skin (cellulitis) and may affect the bone (osteomyelitis); gangrene, which is dead body tissue, develops as a result of poor circulation. Eventually, amputation may be necessary to save the life of the patient.
You Can Arrest the Process
Foot ulcers can be prevented by not wearing shoes that hurt, and examining your feet every day for sores that look like small red craters on the skin. Any sore should be examined and treated immediately, before it can become infected. Vigilance is the best defense against the potentially serious consequences of a foot ulcer.
Because diabetic patients may have nerve damage, they may not be aware of irritation. In these situations, tight or uncomfortable shoes don’t send the usual warning message (pain). Patients with poor vision may want to ask a caregiver or family member to examine their feet daily.
Circulatory problems or peripheral artery disease caused by cholesterol building up on the inside of the arteries may hamper the body’s ability to heal foot ulcers. This happens when blood supply is poor and can’t deliver oxygen to the feet, which makes the skin more vulnerable to ulcers.
Raynaud’s phenomenon, which is characterized by numbness in the fingers and toes, is another risk factor for foot ulcers.
Occasionally, squamous cell carcinoma (skin cancer) may look like a foot ulcer.
Whether or not you have diabetes, foot ulcers may be the start of a more serious medical condition. If you have a sore on your foot, contact one of our clinics in Dallas, DeSoto and Sunnyvale and schedule an appointment.