Ulcers on the legs due to diabetes

Diabetic Foot Ulcer

What leg ulcers in diabetes?

Язвы – медленно заживающие раны на коже. Diabetic foot ulcers occur in individuals with diabetes 1 and 2 type. In 15% People with diabetes are at increased risk of foot ulcers. Diabetic ulcers usually occur in the feet.

Язвы на ногах при диабете – причины

Diabetes can damage the nerves in the legs and feet. This may reduce sensitivity to pain and blisters on these sites. If time does not notice a wound on his leg, It can increase in size and become infected.

Diabetes may also cause problems with blood flow. Poor blood flow makes it difficult healing ulcers.

Ulcer, usually, cause:

• Repetitive trauma or pressure on the foot;
• Stab wound on his leg;
• Objects in the shoe, which can lead to skin damage (eg, small stone).

Risk factors for foot ulcers in diabetics

Factors, that may increase the risk of leg ulcers in diabetes include:

• Neuropathy (numbness, tingling or burning sensation in the legs);
• Peripheral vascular disease (poor circulation in the legs);
• Uncomfortable shoes;
• Cyllosis;
• Diabetes more 10 years;
• Poor control of diabetes (HBA1C> 9%);
• Walking barefoot;
• Smoking.

Язвы на ногах при диабете – симптомы

Tell your doctor, if you have any of the symptoms:

• Sores, sores or blisters on the foot or lower leg;
• Pain;
• Difficulty walking;
• Change the color of the legs: black, blue or red;
• Fever, erythema, swelling, or other signs of infection.

Diagnosis of foot ulcers in diabetics

The doctor will ask about your symptoms and medical history, and perform a physical examination. Tests may include the following:

• Isolation culture wounds, to determine the type of infection;
• Рентген – чтобы определить, Are there any signs of infection in the bone (osteomyelitis);
• КТ или МРТ – чтобы найти полости с гноем (abscess) or look for bone infection;
• Ankle-brachial systolic blood pressure index (LPI);
• Doppler or angiographic examination of blood flow in the legs;
• Determination of glucose and glycated hemoglobin (HBA1C);
• Complete blood count, to determine, есть ли инфекция – высокое количество лейкоцитов может означать наличие инфекции.

Язвы на ногах при диабете – лечение

The earlier start treatment of diabetic foot ulcers, the better the result. Treatment options include the following:

Wound Care

Good wound care can help heal ulcers and prevent infection. Follow your doctor's instructions for the care of the ulcer. Regularly clean the wound. Often change the bandage, to prevent infection.

Reducing the load on leg

Constant pressure on the ulcer can complicate healing. The doctor may ask you to take the weight off the ulcer area. You may be given special shoes,which will remove the pressure on the legs, but let go.

Control of blood sugar

Infection of the ulcer may raise blood sugar levels. High blood sugar can reduce the body's ability to fight infection and wound healing difficult.

Controlling blood sugar will help you fight infections and accelerate the healing of ulcers. Sometimes it will require injections of insulin, to cause blood sugar to normal.

Getting rid of bad habits

If you smoke, to throw. Smoking may impair wound healing.

Skingraft

Some large skin ulcers may not heal quite a long time. You may need skin grafts, to close the wound. For this purpose can be used synthetic material or human skin graft.

Medication

If the ulcer is infected, your doctor may recommend taking antibiotics. Maybe, you have to take medication for 4-6 weeks.

Also, the doctor may recommend medications, that must be applied directly to the ulcer. These medications help speed healing.

The operation to treat ulcers in diabetes

The dead tissue can accumulate in and around the wound and slow down or prevent healing. You may need surgery to remove dead tissue and cleaning wounds. This is called debridement.

It may also be necessary to bypass the blood vessel, to improve blood flow to the feet. This procedure uses healthy blood vessels, to bypass the affected areas. Improved blood flow helps heal wounds.

Sometimes the infection spreads or untreatable. В крайнем случае может быть необходима ампутация – удаление части тела, to stop the further spread of infection.

Other treatments for foot ulcers in diabetes

Hyperbaric oxygen therapy can help accelerate healing of ulcers. The patient is placed in the chamber with pure oxygen, that allows to increase its blood level and hasten healing.

Another variant, help speed up the healing method uses vacuum therapy. For these purposes, a special vacuum device and banding, that creates a negative pressure on the wound and accelerate the healing.

If you are diagnosed with diabetes foot ulcer, Follow your doctor's instructions.

Preventing foot ulcers in diabetics

To reduce the likelihood of foot ulcers in diabetics:

• Daily MY Noggin. Dry them completely, especially between the toes, before putting shoes and socks;
• Do not wear tight-fitting legs socks and stockings;
• You can use Vaseline or lotion, to moisturize dry skin of the feet. Do not apply lotion between the toes. Additional moisture may promote the growth of bacteria;
• Inspect feet daily. Look for wounds and ulcers, you can not feel. Use a mirror or the assistance of another person, To see all sections of the legs;
• The doctor should examine the feet and check their sensitivity at least once a year. If you find an ulcer on his leg, immediately seek medical advice;
• People with diabetes can be brittle nails, which are difficult to cut. You can visit the chiropodist, to gently trim your nails;
• Wear comfortable shoes, not causing strain on feet;
• Quit smoking;
• Talk to your doctor about exercise. Daily exercise can help improve blood flow and reduce blood sugar levels;
• Calluses can increase the pressure on the foot and lead to ulceration. Ask the doctor to remove calluses on the foot, to reduce the risk of foot ulcers;
• Ask the doctor, whether to use a special infrared thermometer, which will help to measure the temperature of the feet;
• Managing diabetes can help reduce the risk of ulcers.

Ulcers, that will not heal, or struck by severe infection can lead to amputation of the foot. About 80% leg amputations are due to foot ulcers in diabetes.