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What Is A Diabetic Wound?

Wound Dressings In Diabetic Foot Disease

Wound Dressings In Diabetic Foot Disease

Wound Healing Research Unit, Department of Surgery, University of Wales College of Medicine Wound Healing Research Unit, Department of Surgery, University of Wales College of Medicine Wound Healing Research Unit, Department of Surgery, University of Wales College of Medicine Wound Healing Research Unit, Department of Surgery, University of Wales College of Medicine Wound Healing Research Unit, Department of Surgery, University of Wales College of Medicine Reprints or correspondence: Dr. K. G. Harding, Wound Healing Research Unit, Cardiff Medicentre, Heath Park, Cardiff, United Kingdom CF14 4UJ ( [email protected] ). Search for other works by this author on: Clinical Infectious Diseases, Volume 39, Issue Supplement_2, 1 August 2004, Pages S100S103, J. R. Hilton, D. T. Williams, B. Beuker, D. R. Miller, K. G. Harding; Wound Dressings in Diabetic Foot Disease, Clinical Infectious Diseases, Volume 39, Issue Supplement_2, 1 August 2004, Pages S100S103, Wound dressings represent a part of the management of diabetic foot ulceration. Ideally, dressings should alleviate symptoms, provide wound protection, and encourage healing. No single dressing fulfills all the requirements of a diabetic patient with an infected foot ulcer. Dressings research in this area is generally poor. However, each category of dressings has particular characteristics that aid selection. Nonadhesive dressings are simple, inexpensive, and well tolerated. Foam and alginate dressings are highly absorbent and effective for heavily exuding wounds. Hydrogels facilitate autolysis and may be beneficial in managing ulcers containing necrotic tissue. Dressings containing inidine and silver may aid in managing wound infection. Occlusive dressings should be avoided for infected wounds. All dressings require frequ Continue reading >>

Diabetic Foot Ulcers

Diabetic Foot Ulcers

Diabetic foot ulcers can be divided into two groups: those in neuropathic feet (so called neuropathic ulcers) and those in feet with ischaemia often associated with neuropathy (so called neuroischaemic ulcers). The neuropathic foot is warm and well perfused with palpable pulses; sweating is diminished, and the skin may be dry and prone to fissuring. The neuroischaemic foot is a cool, pulseless foot; the skin is thin, shiny, and without hair. There is also atrophy of the subcutaneous tissue, and intermittent claudication and rest pain may be absent because of neuropathy. The crucial difference between the two types of feet is the absence or presence of ischaemia. The presence of ischaemia may be confirmed by a pressure index (ankle brachial pressure index < 1). As many diabetic patients have medial arterial calcification, giving an artificially raised ankle systolic pressure, it is also important to examine the Doppler arterial waveform. The normal waveform is pulsatile with a positive forward flow in systole followed by a short reverse flow and a further forward flow in diastole, but in the presence of arterial narrowing the waveform shows a reduced forward flow and is described as “damped.” Continue reading >>

Diabetic Foot Care Article

Diabetic Foot Care Article

A A A Diabetes mellitus (DM) represents several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body's ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. Foot problems commonly develop in people with diabetes and can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot. Sores may develop. Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life-threatening. People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent diabetic complications. People with diabetes should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also l Continue reading >>

Tips For Diabetes Wound Care

Tips For Diabetes Wound Care

A small cut can turn into a large complication when diabetes enters the picture. For one thing, diabetes can lead to a weakened immune system "so a simple cut or scrape can get infected easier than in someone who doesn’t have diabetes,” said Kiersten Weber, DPM, a podiatrist with the University of Oklahoma's Harold Hamm Diabetes Center in Oklahoma City. Neuropathy or nerve damage, one of the many diabetes side effects, also can play a role. Neuropathy can occur because extra sugar in the bloodstream can damage your nerves over time. “It usually starts in the smallest blood vessels, which are in the hands and feet,” explains Dr. Weber, and when you have neuropathy, you have decreased feeling in your feet. As a result, you may not feel pain if you have a cut or blister on your foot, and if you don’t know it’s there and don’t treat it, the sore could become infected. That’s why regularly inspecting your feet for cuts, scrapes, blisters, calluses, and other wounds is such an important part of diabetes care, she said. “If you can’t lift your feet, have someone do it for you and look at the bottom of your feet,” Weber said. “You also can use mirrors to inspect the bottom of your feet if you need.” Preventing Cuts and Scrapes Of course, the best way to protect yourself is to make a serious effort to prevent wounds. Make sure you never walk barefoot, even inside your home, and always wear good-fitting shoes. “I also tell my patients to check the inside of their shoes for stones,” Weber said. “If you have neuropathy, you could get a small stone in your shoe and not know it.” Protect your feet by letting your podiatrist handle even minor foot issues. Don’t try to remove calluses or warts yourself.You might be tempted to try commercial preparati Continue reading >>

Diabetic Ulcers

Diabetic Ulcers

LYRICA is contraindicated in patients with known hypersensitivity to pregabalin or any of its other components. Angioedema and hypersensitivity reactions have occurred in patients receiving pregabalin therapy. There have been postmarketing reports of hypersensitivity in patients shortly after initiation of treatment with LYRICA. Adverse reactions included skin redness, blisters, hives, rash, dyspnea, and wheezing. Discontinue LYRICA immediately in patients with these symptoms. There have been postmarketing reports of angioedema in patients during initial and chronic treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips, and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in patients with these symptoms. Antiepileptic drugs (AEDs) including LYRICA increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses showed clinical trial patients taking an AED had approximately twice the risk of suicidal thoughts or behavior than placebo-treated patients. The estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one patient for every 530 patients treated with an AED. The most common adverse reactions across all LYRICA clinical trials are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, constipation, euphoric mood, balance Continue reading >>

Diabetic Wound Care

Diabetic Wound Care

What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 15 percent of patients with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complication. Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States, and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer have an amputation. Research, however, has shown that the development of a foot ulcer is preventable. Who Can Get a Diabetic Foot Ulcer? Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics and older men are more likely to develop ulcers. People who use insulin are at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. How do Diabetic Foot Ulcers Form? Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain and one may not even be aware of the problem. Your podiatric physician can test feet for neuropathy with a simple and painless tool called a monofilament. Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection. Elevations in blood glucose can r Continue reading >>

Diabetic Wounds

Diabetic Wounds

Diabetes mellitus can be virtually harmless if controlled, but the state of abnormally high blood glucose levels associated with the condition can lead to some serious complications. If left uncontrolled for a long time, or if diabetic patients fail to adapt their lifestyles in order to manage the disease, they will have more difficulty preventing complications from occurring. A serious complication that diabetics may encounter are diabetic wounds. Causes of Diabetic Wounds The main concern with diabetic wounds is poor or delayed healing. Healing problems are caused by the peripheral arterial diseases and peripheral neuropathy that can occur with diabetes, wherein the small blood vessels in different parts of the body, especially in the extremities (hands and feet), grow narrower and reduce the blood circulation to those areas. A lack of circulation in the extremities can result in a reduced supply of oxygen and nutrients to the body tissue and nerves, which is necessary for healing. Over time, nerves in these areas may become damaged, decreasing the sensation of pain, temperature and touch, making patients vulnerable to injury. Types of Diabetic Wounds For a diabetic patient, every wound is a health concern and requires immediate attention. The most common two types are wounds of external origin and wounds of internal origin. Due to peripheral neuropathy, wounds of external origin, such as skin cuts, burns, bumps and bruises, may often go unnoticed by the diabetic patient. If external wounds go unnoticed for some time, delayed treatment can put the patient at risk for further complications. Wounds of internal origin, such as skin ulcers, ingrown toenails or calluses, can lead to the breakdown of skin and surrounding tissue, increasing the risk of bacterial infections. Continue reading >>

Diabetic Wound Care | Foot Health | Patients | Apma

Diabetic Wound Care | Foot Health | Patients | Apma

A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication. Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable. Anyone who has diabetes can develop a foot ulcer.Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers.People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease.Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, footdeformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes.Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack ofability to feel painin the feet due to nerve damage caused by elevated blood glucose levels over time.The nerve damage often can occur without pain, and one may not even be aware of the problem.Your podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament. Vascular disease can complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection.Elevations in blood glucose can reduce the body's ability to fig Continue reading >>

Diabetic Ulcers Treatment & Management

Diabetic Ulcers Treatment & Management

LYRICA is contraindicated in patients with known hypersensitivity to pregabalin or any of its other components. Angioedema and hypersensitivity reactions have occurred in patients receiving pregabalin therapy. There have been postmarketing reports of hypersensitivity in patients shortly after initiation of treatment with LYRICA. Adverse reactions included skin redness, blisters, hives, rash, dyspnea, and wheezing. Discontinue LYRICA immediately in patients with these symptoms. There have been postmarketing reports of angioedema in patients during initial and chronic treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips, and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in patients with these symptoms. Antiepileptic drugs (AEDs) including LYRICA increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses showed clinical trial patients taking an AED had approximately twice the risk of suicidal thoughts or behavior than placebo-treated patients. The estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one patient for every 530 patients treated with an AED. The most common adverse reactions across all LYRICA clinical trials are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, constipation, euphoric mood, balance Continue reading >>

Six Dos And Donts For Diabetes Wound Care

Six Dos And Donts For Diabetes Wound Care

Six Dos and Donts for Diabetes Wound Care Bumps, blisters, scratches, and cuts are a fact of life. For the most part, slapping on a Band-Aid or dabbing some antibiotic ointment does the trick. But if you have diabetes, even the simplest scratch or cut can quickly snowball into an extremely serious situation if youre not extra careful. Ignoring a cut or not treating it the right way, for example, can slow healing, lead to infection, and, in the worst case, possibly result in amputation. The good news? There are steps that you can take to nip possible problems in the bud. Read on to learn how to properly take care of a wound. Look for cuts, blisters, red spots, or swelling. This is especially important to do if you have any loss of sensation in your feet or legs due to diabetic neuropathy . More than 80 percent of amputations start with a foot ulcer . For this reason, make foot checks part of your daily routine say, before you go to bed every night. If you notice a cut that doesnt seem to be healing, or redness that is spreading, call your doctor as soon as you can. If you have trouble seeing or reaching your feet, ask someone to check your feet for you. Or, use a mirror to help you see the bottom of your feet. Dont: Perform any type of bathroom surgery Leave that to the experts. There are different types of wounds, and some wounds require a process called debridement, which is the removal of dead tissue. Debridement helps with wound drainage and healing, and allows for closer inspection. As tempting as it may be to pick or cut off dead skin yourself, avoid doing this at all cost. You can easily end up damaging a blood vessel and worsening the problem. Never cut corns or calluses or use an acid-based wart remover. Gently use a pumice stone, or, better yet, visit a podiat Continue reading >>

Diabetic Foot Ulcer

Diabetic Foot Ulcer

Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot. Wound healing is an innate mechanism of action that works reliably most of the time. A key feature of wound healing is stepwise repair of lost extracellular matrix (ECM) that forms the largest component of the dermal skin layer.[1] But in some cases, certain disorders or physiological insult disturbs the wound healing process. Diabetes mellitus is one such metabolic disorder that impedes the normal steps of the wound healing process. Many studies show a prolonged inflammatory phase in diabetic wounds, which causes a delay in the formation of mature granulation tissue and a parallel reduction in wound tensile strength.[2] Treatment of diabetic foot ulcers should include: blood sugar control, removal of dead tissue from the wound, wound dressings, and removing pressure from the wound through techniques such as total contact casting.[3] Surgery in some cases may improve outcomes.[3] Hyperbaric oxygen therapy may also help but is expensive.[3] It occurs in 15% of people with diabetes,[4] and precedes 84% of all diabetes-related lower-leg amputations.[5] Classification[edit] Diabetic foot ulcer is a complication of diabetes. Diabetic foot ulcers are classified as either neuropathic, neuroischaemic or ischaemic.[6] Risk factors[edit] Risk factors implicated in the development of diabetic foot ulcers are infection, older age,[7] diabetic neuropathy, peripheral vascular disease, cigarette smoking, poor glycemic control, previous foot ulcerations or amputations,[5] and ischemia of small and large blood vessels.[8][9] Prior history of foot disease, foot deformities that produce abnormally high forces of pressure, renal failure, oedema, impaired ability to look Continue reading >>

What’s The Connection Between Diabetes And Wound Healing?

What’s The Connection Between Diabetes And Wound Healing?

Diabetes is a result of your body’s inability to produce or use insulin. Insulin is a hormone that allows your body to turn glucose, or sugar, into energy. If your body has difficulty metabolizing glucose, it can lead to high blood sugar levels. This can affect your body’s ability to heal wounds. In people with diabetes, wounds tend to heal more slowly and progress more quickly, so it’s important to know what to look out for. Although cuts, grazes, scratches, and blisters can occur anywhere on the body, the feet are one of the most common places of injury. A small wound on the foot can quickly develop into a foot ulcer. Foot ulcers can become serious if left untreated. Between 14 and 24 percent of people who have diabetes and develop an ulcer will end up having a lower limb amputation. For this reason, it’s crucial that you do regular self-checks and closely monitor any wounds closely. Catching wounds early is the only way to reduce your risk of complications. Keep reading to learn more about the healing process, ways to speed the healing process along, and how to improve your body’s healing powers long-term. When you have diabetes, a number of factors can affect your body’s ability to heal wounds. High blood sugar levels Your blood sugar level is the main factor in how quickly your wound will heal. When your blood sugar level is higher than normal, it: prevents nutrients and oxygen from energizing cells prevents your immune system from functioning efficiently increases inflammation in the body’s cells These effects slow down wound healing. Neuropathy Peripheral neuropathy can also result from having blood sugar levels that are consistently higher than normal. Over time, damage occurs to the nerves and vessels. This can cause the affected areas to lose sen Continue reading >>

Diabetic Foot Ulcer

Diabetic Foot Ulcer

What is a diabetic foot ulcer? Diabetic foot ulcers are sores on the feet that occur in 15% of diabetic patients some time during their lifetime. The risk of lower-extremity amputation is increased 8-fold in these patients once an ulcer develops. They occur in type 1 and in type 2 diabetes mellitus. What causes a diabetic foot ulcer? A diabetic foot ulcer is caused by neuropathic (nerve) and vascular (blood vessel) complications of diabetes. Nerve damage due to diabetes causes altered or complete loss of feeling in the foot and/or leg. This is known as peripheral neuropathy. Pressure from shoes, cuts, bruises, or any injury to the foot may go unnoticed. The loss of protective sensation stops the patient from being warned that the skin is being injured and may result in skin loss, blisters and ulcers. Vascular disease is also a major problem in diabetes and especially affects very small blood vessels feeding the skin (microangiopathy). In this situation a doctor may find normal pulses in the feet because the arteries are unaffected. However other diabetic patients may also have narrowed arteries so that no pulse can be found in the feet (ischaemia). The lack of healthy blood flow may lead to ulceration. Wound healing is also impaired. Vascular disease is aggravated by smoking. What are the signs and symptoms of diabetic foot ulcer? It is not unusual for patients to have had diabetic foot ulcers for some time before presenting to a health professional, because they are frequently painless. Depending on severity, a diabetic foot ulcer may be rated between 0 and 3. 0: at risk foot with no ulceration 1: superficial ulceration with no infection 2: deep ulceration exposing tendons and joints 3: extensive ulceration or abscesses Tissue around the ulcer may become black due to t Continue reading >>

Diabetic Foot

Diabetic Foot

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your nerves or blood vessels. Nerve damage from diabetes can cause you to lose feeling in your feet. You may not feel a cut, a blister or a sore. Foot injuries such as these can cause ulcers and infections. Serious cases may even lead to amputation. Damage to the blood vessels can also mean that your feet do not get enough blood and oxygen. It is harder for your foot to heal, if you do get a sore or infection. You can help avoid foot problems. First, control your blood sugar levels. Good foot hygiene is also crucial: Check your feet every day Wash your feet every day Keep the skin soft and smooth Smooth corns and calluses gently If you can see, reach, and feel your feet, trim your toenails regularly. If you cannot, ask a foot doctor (podiatrist) to trim them for you. Wear shoes and socks at all times Protect your feet from hot and cold Keep the blood flowing to your feet NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

Diabetic Foot Pain And Ulcers: Causes And Treatment

Diabetic Foot Pain And Ulcers: Causes And Treatment

Foot ulcers are a common complication of poorly controlled diabetes, forming as a result of skin tissue breaking down and exposing the layers underneath. They’re most common under your big toes and the balls of your feet, and they can affect your feet down to the bones. All people with diabetes can develop foot ulcers and foot pain, but good foot care can help prevent them. Treatment for diabetic foot ulcers and foot pain varies depending on their causes. Discuss any foot pain or discomfort with your doctor to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected. One of the first signs of a foot ulcer is drainage from your foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms of a foot ulcer. The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because of an absence of healthy blood flow to the area around the ulcer. Partial or complete gangrene, which refers to tissue death due to infections, can appear around the ulcer. In this case, odorous discharge, pain, and numbness can occur. Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected. Talk to your doctor if you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated. Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 3 using the following criteria: 0: no ulcer but foot at risk 1: ulcer present but no infection 2: ulcer deep, exposing joints and tendons 3: extensive ulcers or abscesses from infection Diabetic ulcers a Continue reading >>

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