Ulcers
Description
An ulcer is a breakdown of the skin on an area of the foot. It can develop quickly and may be painful and difficult to heal. It often comes as a result of callus or corns being allowed to build up hard skin and resulting in extreme pressure squeezing the tissues in the affected area and becoming starved of nutrients and oxygen. The local tissues then die off. Infection is a common complication.
Sometimes we might advise you to have imaging to determine whether the infection has penetrated to the bone. This can happen to anyone but is more likely and more serious in people with diabetes.
Some likely causes
- Biomechanical issues leading to areas of high pressure.
- Poorly controlled and undiagnosed diabetes mellitus.
- Vascular insufficiency
- Lack of sensation
- Trauma
What we can do
- Perform a physical examination.
- Offload the area with pads or insoles.
- Perform debridement and wound care.
- Laboratory tests.
- Footwear advice
- Referral to some specialists that include a diabetologist, endocrinologist, Hospital diabetic foot team, vascular surgeon, diabetes specialist nurse, radiologist, Orthotist and infectious disease specialist.
- Refer for imaging.