A diabetic foot trophic ulcer is an open sore or wound that occurs, as the name suggests, in those with severe and chronic diabetes. It occurs due to pressure and is commonly located on the bottom of the foot. It occurs in about 15 percent of patients with diabetes. Of those with a diabetic foot trophic ulcer, about 6 percent will be hospitalized due to infection or any other ulcer-related complication. While there are several complications associated with a diabetic foot trophic ulcer, amputation is the most common. However, prevention of a diabetic foot trophic ulcer is possible.
Causes of a Diabetic Foot Trophic Ulcer
Anyone who has diabetes can develop a diabetic foot trophic ulcer. However, people who use insulin are at greater risk of developing this ulcer, as are patients with diabetes-related eye, kidney, and heart disease. If you are overweight with diabetes and regularly use alcohol and tobacco, you are also more likely to develop this ulcer.
These ulcers form due to several factors, such as friction, pressure, or irritation in the foot; a lack of feeling in the foot; poor circulation; foot deformities; trauma, and the duration of diabetes. If you have diabetes for many years, you can also develop neuropathy.
This is a reduced or complete lack of ability to feel pain in the feet, due to nerve damage caused by high blood glucose levels over time. This nerve damage can occur without pain and you may not even be aware that you have a problem. Diabetes can complicate your foot ulcer by reducing your body’s ability to heal and increasing the risk for an infection. Also, elevation in blood glucose levels can reduce the body’s ability to fight infection and can also slow healing.
Symptoms and Diagnosis of a Diabetic Foot Trophic Ulcer
Some of the early symptoms of a diabetic foot trophic ulcer are an unusual swelling, redness, irritation, and odours from one of both feet. Also, one of the first signs is drainage from your foot that will stain your socks or leak out from your shoes.
If you have an advanced or more serious diabetic foot trophic ulcer, you may develop black tissue, called eschar, surrounding the ulcer. This develops due to a lack of healthy blood flow to the area around the ulcer. In advanced cases, partial or complete gangrene, which is the death of the tissue due to infection, can appear around the ulcer. In this case, numbness, pain, and a discharge with a peculiar odour can occur.
The signs and symptoms of a diabetic foot trophic ulcer are not always obvious. In fact, you may not even know that you have this ulcer till it becomes infected. If your skin becomes discolored or turns black, or if you feel pain around an area with increased irritation, you should immediately consult your doctor.
Your doctor will classify the seriousness of your ulcer using the Wagner Ulcer Classification System on a scale from 0 to 5, as follows:
- 0: You have no open lesions and may have healed lesions
- 1: You may have a superficial ulcer without penetration to deeper layers
- 2: You have a deeper ulcer, reaching tendon, bone, or joint capsule
- 3: Your deeper tissues are involved, with abscess, osteomyelitis, or tendonitis
- 4: You have gangrene in a portion of your forefoot or heel
- 5: You have extensive gangrenous involvement of the entire foot
Treatment of Diabetic Foot Trophic Ulcers
If you have a diabetic foot trophic ulcer, you can follow certain key tenets of wound care, including:
- Lowering your blood sugar
- Performing appropriate debridement of wounds
- Reducing friction and pressure
- Treating any infection
- Restoring adequate blood flow
Your doctor may also recommend that you wear certain appliances that can protect your feet, including shoes designed for people with diabetes; casts; foot braces; compression wraps, and shoe inserts to prevent corns and calluses.
You may also be treated to prevent infection of an ulcer with footbaths; disinfecting the skin around and ulcer; keeping the ulcer dry with frequent dressing changes; enzyme treatments, and dressings containing calcium alginates to prevent bacterial growth.
Your doctor may also prescribe certain medications, such as antibiotics, antiplatelets, or anti-clotting medications, to treat your ulcer if the infection progresses, even after anti pressure or preventive treatments. Several of these antibiotics attack Staphylococcus aureus, which causes staph infections, as well as ß-hemolytic Streptococcus, which are normally found in the intestine. You should talk to your doctor about other health conditions you may have that can increase your chances of getting infected by these bacteria.
Your doctor may also recommend surgical treatment for your diabetic foot trophic ulcer. A surgeon can help reduce pressure around your ulcer, by shaving down the bone, or by removing foot abnormalities, such as hammertoes and bunions. If no other treatment can help your ulcer heal, surgery can prevent your ulcer from becoming worse or can prevent amputation.
Surgery for a diabetic foot trophic ulcer is a relatively involved procedure. You must choose the right surgeon for the treatment of your diabetic foot trophic ulcer. One such surgeon, located in Hyderabad, India, is Dr. S. Suma, of Prettyu.com. She is a skilled cosmetic, plastic, and reconstructive surgeon.
She will carefully take your detailed history during that vital first consultation and will understand your unique case. She will not treat you like any other person but will treat you holistically. She is extremely empathetic and compassionate as well as extremely skilled, and will completely understand the pain and discomfort you are going through with your diabetic foot trophic ulcer.
She will work closely with your other doctors to come up with a treatment plan just for you. She will do her best to ensure that your diabetic foot trophic ulcer does not become more serious and that you do not require amputation. She will draw up a plan for your diabetic foot trophic ulcer treatment.
So, if you need treatment for your diabetic foot trophic ulcer, do consult with Dr. S Suma for diabetic foot trophic ulcer treatment in Hyderabad, and make no mistake that you have made the right choice!
To know more about the treatment for Diabetic Foot Trophic Ulcers, as well as the other cosmetic and reconstructive surgery procedures that Dr. S. Suma performs, you can get in touch with her at +91 86 86 042 042 or email her at info@prettyu.com or visit her website at www.prettyu.com.
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