Diabetic Foot Ulcer – Causes, Symptoms & Advanced Treatment

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What Is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that commonly develops on the sole, toes, heel, or sides of the foot. A small cut, blister, or crack can progress into a deep ulcer in diabetic patients because of:

  • Neuropathy which causes decreased sensation
  • Peripheral artery disease causes Koi poor blood supply
  • Increased pressure on the foot
  • Delay in healing of wound

Early treatment is required in diabetic foot ulcer patients as it is a major cause of hospitalization and limb amputation.

Causes of Diabetic Foot Ulcer

Diabetic foot ulcers occur due to multiple diabetes-related complications:

1. Diabetic Neuropathy (Nerve Damage)

As there is nerve damage in diabetic patients it causes loss of sensation and prevents the patient from feeling cuts, blisters, burns and foot injuries. This causes the injury to  worsen without the patient realizing it.

2.Poor Blood Circulation (Peripheral Artery Disease)

Peripheral arterial disease causes the arteries to block and reduce the blood flow, which  reduces oxygen supply, wound healing and infection fighting. This increases ulcer risk and slows down recovery.

3.Foot Deformities

Conditions such as Hammer toe, Claw toe, Bunions and Charcot foot cause abnormal pressure points and leads to skin breakdown and ulcers.

4.Improper Footwear

Tight or ill-fitting shoes can cause friction, corns, calluses and pressure wounds which can turn into ulcers.

5.High Blood Sugar Levels

High blood sugars reduces the immunity, decreases the wound healing and weakens skin integrity. This makes the patients more prone to ulcers and infections.

Symptoms of Diabetic Foot Ulcers

Early recognition is crucial. Common symptoms include:

  • Open wound or sore that does not heal
  • Redness or swelling around the area
  • Discharge or pus
  • Foul smell from the foot
  • Blackened or dead tissue (necrosis)
  • Foot pain (may be absent due to neuropathy)
  • Hard callused skin around a wound
  • Fever or chills in case of infection

If any of these symptoms appear, immediate medical attention is needed.

Diabetic Foot Ulcer Treatment – Complete Care Approach

Effective treatment requires a multidisciplinary, specialized diabetic foot care team. The goals of treatment are to:

a. Remove dead tissue

b. Infection control

c. Reduce wound pressure

d. Restore blood flow

e. Promote faster healing

At Happy Diabetic Foot and Podiatry Center we use the below mentioned approach.

1. Advanced Wound Care & Debridement

Debridement is the removal of dead tissue, infected skin and calluses. It improves healing, reduces infection risk and stimulates healthy tissue formation.

Types of debridement offered:

  1. Surgical debridement
  2. Enzymatic debridement
  3. Autolytic debridement
  4. Mechanical debridement

2. VAC (Vacuum-Assisted Closure) Dressing

VAC or Negative Pressure Wound Therapy (NPWT) is a modern technique that uses controlled suction to heal diabetic foot ulcers faster.

Benefits of VAC Dressing:

  • Removes excess fluid
  • Reduces bacterial load
  • Improves blood flow
  • Promotes granulation tissue formation
  • Speeds up healing time
  • Helps close deep and complex wounds

VAC dressing is highly effective for chronic ulcers, large wounds, post-surgical wounds

3. Infection Control & Antibiotic Therapy

Diabetic foot ulcers commonly get infected due to low immunity.

Infection management includes:

  • Oral or IV antibiotics
  • Pus drainage
  • Culture-based antibiotic selection
  • Regular wound cleaning
  • Strict blood sugar control

In severe infections, hospitalization may be required.

4. Offloading (Pressure Relief)

Reducing pressure on the ulcer is very important for healing.

Offloading techniques include Total contact cast, Diabetic footwear, Orthotic insoles, Walking boots, Custom padding. This prevents further injury and allows faster healing.

5. Vascular Evaluation & Blood Flow Improvement

Poor circulation is one of the biggest reasons ulcers don’t heal.

Assessments include:

  1. Doppler scan
  2. Ankle-Brachial Index (ABI)
  3. CT angiography

If needed:

  • Angioplasty
  • Stenting
  • Bypass surgery

Restore blood flow and improve healing rates.

6. Surgical Reconstruction (Advanced Cases)

For deep ulcers, exposed bone, or severe infection, surgical management may be required.

Surgical options:

  1. Debridement with closure
  2. Skin grafting
  3. Flap reconstruction
  4. Tendon lengthening
  5. Bone correction surgery
  6. Amputation (only when life-saving)

Reconstruction aims to save the limb, restore function, prevent future ulcers

Prevention of Diabetic Foot Ulcers

  • Maintain good blood sugar control
  • Wear proper diabetic footwear
  • Inspect your feet daily
  • Trim nails carefully
  • Avoid walking barefoot
  • Keep skin moisturized
  • Treat minor injuries immediately
  • Regular podiatry check-ups

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