Foot ulcerations are crater-like lesions of the foot that often appear as open, red and sometimes deep sores. At times, the tendons or bones may be involved. Diabetic patients are more prone to these types of foot issues and, when infected, have a more difficult time healing. The progression of an ulcer can be quite serious. If left untreated or if infection takes hold, a puss pocket can develop, the infection can spread to the fat and/or bones, and the infection can even result in gangrene. Gangrene of the toe, foot or leg could lead to amputation.
Causes
Foot ulcers are more likely to occur in patients suffering from poor circulation, bone abnormalities or nerve damage.
Nerve damage: When a patient loses sensation of the foot, he or she is unlikely to realize there is a cut or some type of injury to the foot. Left untreated, the cut may be subject to ongoing irritation and left open to becoming infected.
Poor circulation: Circulation problems are common in diabetic patients. A reduction of blood flow to any area of the body deprives it of necessary oxygen to promote healthy skin and slows healing.
Bone abnormalities: Any bone protrusions, such as hammertoe or bunions, can rub against the side of the shoe and become irritated, resulting in an ulcer.
Symptoms
Ulcers are usually found on the bottom of the foot or the end of a toe. They appear as round, indented sores, occasionally surrounded by thickened, callous skin. Severe ulcers may reveal tendons or bone beneath them.
In cases of normal nerve function, ulcers can be very painful. When a nerve pathology is present, the patient may not be aware of the injury without frequent inspection of the feet. Older or obese patients may not be able to view injury to the bottom of the foot on their own.
Treatments
Treatment by a physician will depend on whether or not the ulcer is infected. Your physician may run blood tests, take X-rays or perform tests to determine whether the ulcer was caused by any foot abnormalities, circulation problems or nerve damage.
If there is no nerve damage, the doctor may debride the ulcer (remove damaged tissue), dress the area and prescribe footwear to alleviate any pressure on the affected area.
Some cases may require surgery, depending on the severity and cause of infection.
Prevention
Checking the feet for injuries, especially on patients experiencing loss of sensation, is important in the early detection of injury. Good foot hygiene, involving the daily washing of the feet with soap and water and thorough drying, will help ward off infections.
Diabetic patients may want to rely on their physicians for toenail trimming to reduce risk of injury.