WOUND CARE
Podiatrists, Wound Care Specialists serving Miami and Hialeah, FL area
Diabetic Wounds
Patients with diabetes are prone to the development of foot ulcers. After years of elevated blood sugar, both nerves and small blood vessels in the feet are damaged. Patients therefore do not feel small injuries occur, and damage to the circulation predisposes people to the development of wounds that may not heal. Diabetes also affects the immune system, leading to an increase chance of infection of foot ulcers.
Diagnosis - Ulcers can form on the feet of people with diabetes, usually after an injury or in places that receive constant pressure, such as the ball of the foot. Further testing can be done to assess the circulation of the foot, and to determine the extent of the loss of sensation.
Treatment - Because pain from infection or enlarging of an ulcer might not be felt, diabetic foot ulcers need to be closely monitored for progression or infection. Calluses on the foot or around the wound should also be monitored regularly and treated when necessary. In some cases, alterations can be made to footwear to promote healing. Topical medications can be applied to encourage wound healing.
Without Treatment - Diabetic ulcers may become deep or infected. In cases of bone infection, long courses of intravenous antibiotics may be required. In some cases amputation of the affected toe may be necessary.
Charcot Foot
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance. Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation. Because of its seriousness, it is important that patients with diabetes-a disease often associated with neuropathy-take preventive measures and seek immediate care if signs or symptoms appear.
Diagnosis - The diagnosis of Charcot foot can be made on the basis of loss of normal shape and structure of the foot and ankle. This can bee seen on physical exam, and demonstrated by X-ray or MRI.
Treatment - Ideally, the treatment of Charcot foot includes treatment of the underlying condition causing the loss of sensation. During acute pain, the foot can be immobilized and anti-inflammatory medication can be taken. Measures are taken to maintain the proper shape and weight bearing of the foot and ankle.
Without Treatment - As Charcot foot progresses, chronic ulcers can develop. These are painful and can lead to infection.