A foot ulcer is an open sore or wound that occurs in approximately 15% of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication. Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States with a rate of 14-24% of patients requiring an amputation. However, research has shown that development of a foot ulcer is preventable.

What causes a foot ulcer?

Anyone who has diabetes can develop a foot ulcer. People who use insulin, are at a higher risk of developing a foot ulcer, as are patients with kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (friction or pressure), and trauma. Diabetic patients can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage. Having a vascular disease can further complicate a foot ulcer, reducing the body’s ability to heal.

How to properly diagnose and treat a foot ulcer?

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 an infection. Key factors to treatment of a foot ulcer include prevention of infection, taking the pressure off the wound, removing dead skin and tissue, applying medication or dressings to the ulcer, and managing glucose and other health problems.

For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Special footgear such as custom braces or specialized casting will help in reducing the pressure and irritation to the area with the ulcer.