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Diabetic Foot Ulcers
WHAT YOU NEED TO KNOW:
A diabetic foot ulcer can be redness over a bony area or an open sore. The ulcer can develop anywhere on your foot or toes. Ulcers usually develop on the bottom of the foot. You may not know you have an ulcer until you notice drainage on your sock. Drainage is fluid that may be yellow, brown, or red. The fluid may also contain pus or blood.
Call your local emergency number (911 in the US) if:
- You have a fever with chills.
- You begin vomiting.
- You feel faint or become confused.
Call your doctor if:
- You see new drainage on your sock.
- Your foot becomes red, warm, and swollen.
- Your foot ulcer has a bad smell or is draining pus.
- You feel pain in a foot that used to have little or no feeling.
- You see black or dead tissue in or around your ulcer.
- Your ulcer becomes bigger, deeper, or does not heal.
- You have questions or concerns about your condition or care.
- Antibiotics may be given to help treat or prevent a bacterial infection.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Care for your wound as directed:
A bandage will be put on your ulcer. Your healthcare provider will give you instructions on changing your bandage. You may need to clean the wound and change the bandage daily. The bandage may contain medicines to help your ulcer heal. You may be asked to put medicine on your foot ulcer before putting on the bandage. The medicine may also prevent growth of tissue that is not healthy. You may need to cover your wound with a plastic bag while you bathe. Ask your healthcare provider for instructions on bathing until your foot heals.
Prevent diabetic foot ulcers:
Good foot care may help prevent ulcers, or keep them from getting worse. Ask someone to help you if you are not able to check your feet by yourself. You or another person may need to do any of the following:
- Keep your blood sugar levels under control. Continue the plan for your diabetes that you and your healthcare provider have discussed. Healthy food choices and taking your medicines as directed may help control blood sugars. Contact your healthcare provider if your blood sugar levels are higher than directed.
- Wash your feet each day with soap and warm water. Do not use hot water, because this can injure your foot. Dry your feet gently with a towel after you wash them. Dry between and under your toes.
- Apply lotion or a moisturizer on your dry feet. Ask your healthcare provider what lotions are best to use. Do not put lotion or moisturizer between your toes. Moisture between your toes could lead to skin breakdown.
- Check your feet each day. Look at your whole foot, including the bottom, and between and under your toes. Check for wounds, corns, and calluses. Feel your feet by running your hands along the tops, bottoms, sides, and between your toes. Use a nonbreakable mirror to check your feet if you have trouble seeing the bottoms. Do not try to remove corns or calluses yourself. File or cut your toenails straight across.
- Protect your feet. Do not walk barefoot or wear your shoes without socks. Check your shoes for rocks or other objects that can hurt your feet. Wear cotton socks to help keep your feet dry. Wear socks without toe seams, or wear them with the seams inside out. Change your socks each day. Do not wear socks that are dirty or damp.
- Wear shoes that fit well. Wear shoes that do not rub against any area of your feet. Your shoes should be ½ to ¾ inch (1 to 2 centimeters) longer than your feet. Your shoes should also have extra space around the widest part of your feet. Walking or athletic shoes with laces or straps that adjust are best. Ask your healthcare provider for help to choose shoes that fit you best. Ask him or her if you need to wear an insert, orthotic, or bandage on your feet.
- Do not smoke. Nicotine can cause damage to your blood vessels and increases your risk for foot ulcers. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
- Know the risks if you choose to drink alcohol. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
- Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes. Ask him or her to help you create a weight loss plan if you are overweight. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.
Follow up with your healthcare provider or foot specialist as directed:
You may need to return often to have your wound checked. Your wound may be measured to see if it is getting smaller. Bring any offloading devices or footwear to your follow-up visits so your healthcare provider or specialist can check them. Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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