A foot ulcer is an open wound on the foot that can be superficial or extend all the way into the foot, exposing tendon and bone. When it becomes infected, it takes a very long time to heal. It is necessary to “offload” (modify shoes or insoles so the ulcer does not contact pressure when walking), change walking habits and treat medically. Those with diabetes and peripheral neuropathy or at particular risk because they won’t always sense pain from an ulcer. Foot structure and function tends to break down in these high risk individuals, making them even more vulnerable.
Non-healing or untreated foot ulcers progress to abscess (a localized pocket of pus), an area of cellulitis (infection of soft tissue), osteomyelitis (bone infection) or gangrene. In persons with diabetes, a seemingly simple foot ulcer is the initial problem in approximately 85 percent of severe foot infections that ultimately require amputation of some part of the lower limb. Approximately 15% of diabetics develop foot ulcers. Half of those will have another occurrence within 1 year.
Those with circulatory problems are also at risk. Keeping calluses cut down, correct footwear selection, regular exercise and good diet are all vitally important in managing this risk. Since normal weight bearing exercises are problematic with this condition, aerobic arm workouts increase blood flow in the legs. An arm ergometer – a tabletop device that has bicycle-like pedals that are operated by the arms is one way to do it.
Other names or similar foot conditions:
- Neuropathic foot ulcer
Symptoms:
- Open wound on foot
- Pain at site
- Higher temperature and swelling in foot with wound
Signs to look for:
- Open wound on foot
- Pain at site
- Foul odor
- Higher temperature and swelling in foot with wound
Possible Causes:
- Diabetes combined with poor footwear, unmanaged calluses and/or diet
- All those with circulatory impairment are at risk – diabetes, heart disease, Raynaud’s syndrome, peripheral neuropathy
Goals:
- Manage medically (Wound Clinic or similar facility)
- Take pressure off ulcered areas (off load)
- Shoe wear to accommodate bandaging and provide stability
- Sock wear to protect foot
How We Help:
Arch Supports:
- Off load ulcer with plastazote topped cushion and metatarsal pad, such as Hapad
Shoes:
- While wounds healing, wear Acor 1203 shoes – silver lined with lycra top and offload wounds with plastazote cushion
- Extra depth, double or triple depth shoe with high toe box, firm heel counter, rocker sole and connecting shank
- For Smart footwear, wear rocker soles or shoes with titanium springs
- Avoid flip-flops. Only wear sandals with a back and only the Orthaheel, Alegria or Aetrex brand
- Go barefoot only minimally
- Do not wear pumps or heels
Other:
- If diabetic, special attention to exercise, diet and proper footwear
- Wear socks
- Copper, bamboo or silver socks that wick moisture away from the skin and prevent infection
Activities:
- Regular exercise program
- Use arm ergometer while unable to bear weight during wound healing
- Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling
This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care. The information has been compiled from sources available to the general public and referenced below. Copyright 2010 Carole Romig
Sources Image: Indiahealthtour.com Text: jacksonfootdoctor, eHow.com, Defeatdiabetes.org