Diabetic Foot & Wound Care
Foot care for diabetics is essential to keeping their feet healthy and safe! Without proper foot care, diabetics run the risk of foot or toe amputations.
Foot care is essential to those with Diabetes. Without proper foot care supervision, diabetics face the possibility of serious complications such as neuropathy, ulcers, even amputations. We have many resources at our office to keep your feet safe, protected and healthy. With proper shoes, socks, and medical supervision, diabetics will have healthy feet for life.
According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Preventing Foot Problems
Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal.
When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.
The good news is that most of these problems can be prevented through regular podiatric visits, patient education, daily foot inspection and care, proper footwear, and early recognition and treatment of any suspected trouble areas. This can only be accomplished with active participation in your own care along with the help and guidance of your foot specialist.
Most Common Foot Problems For Diabetics:
1. Poor circulation
A corn is simply an area of hard, thickened skin that can occur on the top, between, or on the tip of the toes.
A callus is similar in nature, but is larger and usually occurs across the ball of the foot, on the heel, or on the outer side of the great toe. Corns and calluses are often mistakenly considered a "skin" condition. They are actually the visible sign of an underlying "bone" problem.
Everyone knows that "big oaks from little acorns grow", but few realize that "big aches from little toe corns grow". Calluses and corns quite often have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.
How Do I Know It's a Corn or Callus?
First, your doctor will conduct a thorough inspection of these areas. He/she may gently trim some of the thickened skin away, in order to rule out a wart (caused by a viral infection of the skin) as the culprit. X-rays will often be taken to identify the specific bone problem that is causing the corn or callus.
The doctor may place a small marker on the corn before taking the x-ray, to make it’s location visible on the x-ray. The finished x-ray will then show the location of the corn and the bone spur underneath that caused it.
What Causes Corns or Calluses?
Corns and calluses form due to repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure, in order to keep you from getting an open sore or blister. Small amounts of friction or pressure over long periods of time cause a corn or callus.
Large amounts of friction or pressure over shorter periods of time cause blisters or open sores. Corns can be due to a buckled or contracted toe position called a hammer toe. Often toes curl under the neighboring toe (especially the smallest toe) causing corns to form.
Calluses develop under a metatarsal head (the long bone that forms the ball of the foot) that is carrying more than its fair share of the body weight, usually due to it being dropped down or due to its longer length. (Figure 2) Many of these bone conditions are inherited. A poor choice of shoes can aggravate corns and calluses, but often it is not the "sole" cause. (No pun intended.)
Home Treatment for a Corn or Callus
Trimming of this thick skin can relieve the pressure for a short time. You should never consider doing this yourself if you are diabetic or have poor circulation. If you cut yourself, you may cause an infection.
Corn pads and callus removers often have harsh acids that peel this excess skin away after repeated application, but they can cause a severe chemical burn, which might lead to infection and greater pain than the original foot condition....so be careful with self-care.
You can begin by soaking your feet in warm soapy water and gently rubbing away any dead skin that loosens. A pumice stone, buff bar or emery board is then use to "file" this thickened skin. This should be done gradually, a bit a time, ideally after each shower or bath.
Attempting to file off the entire thickness of a corn or callus can result in a burn or abrasion. Applying a good moisturizer such as Vitamin E oil, cocoa butter, or lanolin to the hardened areas should keep them softer and relieve pain.
Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can be purchased to protect corns and calluses, but should be removed carefully, so you do not tear the skin, and should only be worn for a day at a time.
How Will Your Doctor Remove a Corn of Callus?
After an initial history and physical exam of your feet, x-rays will be needed to tell the whole story and determine why corns and calluses are developing. Your doctor is the expert in trimming down these areas of thick skin and will often apply comfortable padding to these painful corns and calluses.
Special padding devices and materials may be available only from your doctor for your use at home. Medication for inflammation may be utilized to treat the underlying injury and sometimes a cortisone injection into the underlying bursal sac will be recommended to rapidly reduce pain and swelling.
Changes in shoe wear may be recommended. A prescription custom-made device called an orthotic might be made to wear inside your shoes, to redistribute pressure more evenly across the ball of your foot. A pad placed in your shoes (called a metatarsal pad) may help reduce your contracted hammer toes and relieve pressure on the ball of the foot as well.
Often corns and calluses will have to be trimmed on a regular basis to prevent them from hurting. Eventually, you may desire corrective foot surgery by your podiatrist to straighten curled or contracted toes for corns or elevate and shorten metatarsals for calluses.
Often such surgery represents a short term inconvenience to your lifestyle, but will not require any lengthy period of rest or inactivity. Many satisfied patients have remarked that surgery to remove the bone beneath the corn hurts less the very next day than on a painful day walking in their shoes with the corn present.
Preventing Corns and Calluses
Often changing your style or size of shoes may help. Carefully review the shoes in your closet. Check their fit and discard any that have seams and stitching over painful corns or have worn out innersoles that offer too little protection for calluses on the ball and heel of your foot.
Make sure shoes are wide enough for your feet and have enough depth in the toe area to allow minimal pressure on the toes. To demonstrate whether your shoes are of adequate size and shape, place your foot on a blank sheet of paper and trace the shape of your foot.
Then, place the shoe in question on top of your foot tracing. You may be surprised, as are many people, that your shoes are actually smaller and narrower than your feet. Try to imagine the forces present in that shoe when you squeeze your foot into it and then walk at any speed. Ouch !
Review the socks in your drawer. If they have thick seams at the toes or holes, it's time to go shopping. Try to choose natural materials such as cotton and wool. Several types of socks (such as Thor-lo brand) have a double thickness in the toes and heels to protect these areas. Nylon hose can be purchased that have a woven cotton sole on the bottom of the foot to offer less friction and more padding.
Corns and calluses almost always persist until corrective surgical measures are taken, so don't become discouraged if your efforts to prevent them are less than successful.
FOOT WOUNDS / ULCERS
Having an ulcer, wound, or significant infection on your feet or ankles can be frightening and painful. Thankfully, modern medicine provides us with numerous treatment options to help you heal. If you need help with limb salvage or wound care, reach out to our award-winning podiatrist in Plano, TX.
Common Wound Care Conditions We Treat
If you or a loved one suffers from any of the following conditions, our expert podiatric team can help:
Lower extremity ulcers
At New Horizon Foot and Ankle Specialists, we recognize the physical and emotional pain that can arise when you are faced with a debilitating wound. Our goal is threefold when you visit Dr. Ufondu, in Arlington, Tx.
1. Control and manage your pain
2. Prevent or resolve any infection
3. Maintain function in your foot or lower extremity
Whether your wound is small or large, our trusted podiatrists will employ their extensive knowledge of foot wound care and lower extremity wound care to help you control and resolve your condition.
Diabetic neuropathy is caused by damaged nerves. With these nerves damaged, it is difficult for your body to process feeling throughout your body. You may experience burning or tingling at first, but as the condition progresses, your may not have any feeling.
While this may not sound all bad, it can have very serious effects. You may not feel a small stone in your shoe or notice when your new shoes begin to rub on your big toe. After all day of this rubbing, you can develop an ulcer or infection.
Diabetic shoes are so important in keeping your feet safe. They are specifically designed to prevent very serious ulcers and infections in diabetics. To start, they have a wider toe box to give you more room and less rubbing.
They don't have seams in their lining to prevent and cutting friction. Preventing problems with your feet is the best way to prevent serious complications from diabetes.
Diabetic Routine Care
We see many diabetics routinely to help prevent problems. Dr. Ufondu, will examine the foot and note any changes to the skin or nails. She will check for any area of weakness or pain. Our doctors will also cut the patient's toenails to make sure they are trimmed properly to keep problems, such as ingrown toenails, away.
It is important that you routinely see a podiatrist to keep your feet safe and healthy. In order to keep your whole body safe, you need to have a team of doctors that routinely check and monitor your body, most serious complications can be prevented.