Having a diabetic foot sore, ulceration, or foot wound can be a very frightening and real event in one’s life. This can be even more unnerving if one has a family history of amputation. Losing a limb can shorten one’s life substantially by increasing stress on the opposing non-amputated limb, leading to its amputation as well. In addition, losing a limb can create immense stress on the heart and body systems due to the difficulty of bearing weight on only one limb leading to shortened life expectancy.
While the facts behind foot wounds and ulcerations can be alarming, one is not without an element of control. Many foot injuries can be prevented by simply getting one’s foot measured with what is known as a Brannock Device. It is common for patients with neuropathy to wear tighter or smaller shoes as they “feel better” due to the pressure when in fact they are too small creating skin injury that brings about the sore or ulceration in the first place. Our Board-Certified Podiatrists recommend getting fitted by your podiatrist or by a certified shoe fitter known as a Pedorthist.
Besides wearing the correct size, skin injury can be prevented by wearing what is known as an extra depth shoe. This is different from your typical shoe as it is usually seamless on the inside, slightly taller in the toe box with more relaxed materials, and more forgiving than most shoes, preventing injury in the first place. These shoes can be purchased from your podiatrist, pedorthist or direct from select manufacturers such as Dr. Comfort. These shoes are very forgiving for foot deformities such as bunions and hammer toes and when purchased, they come with special diabetic insoles designed to reduce pressure and callus formation that lead to ulcerations or holes in the feet.
While extra-depth shoes and insoles can reduce the chance of skin injury and foot ulcerations, our podiatrists recommend you consult with your podiatric surgeon or orthopedic surgeon to see if one’s foot structure warrants surgical correction.
It is important to tell your doctor if you are unable to walk 1 to 2 blocks without discomfort or if you experience leg pain in the nighttime that awakens you from sleep. This may be an indication that your legs are not getting enough blood flow and you may need additional studies such as an arterial doppler, a type of ultrasound that checks the blood flow in the legs. In select cases, a vascular surgeon may need to perform a study known as an angiogram, where dye is injected into the leg to assess the blood flow and map the blood vessels of the legs.
Daily visual exams of the feet and legs and shoes are of absolute importance in preventing skin injury, foot sores, and wounds. If you notice any of the above, seek help immediately and avoid self- treatment. If one can not reach their feet, it is recommended to have a family member examine one’s feet or purchase a hand-held mirror like one used at a hair salon or if needed, a handheld telescoping mirror that can be used independently.
If you have Diabetes, see your podiatrist annually at the minimum to assess your blood flow, nerve supply, and foot structure. It should be noted that if one has neuropathy or vascular disease without foot ulcerations or wounds, they are likely going to be seen by their podiatrist every 3 months to prevent problems. Naturally if one ever notices redness, cracks in the skin, drainage, non-healing wounds or anything that does not look normal then seek help immediately.
Remember that, should one develop ulceration or wound in the foot and leg, there are things the patient can do to help increase the chances of healing and prevent amputation. All you have to do is ask your doctor, “What can I do when I am not at my visit to help my wound or foot sore heal?” You might be surprised and your recovery may be sooner than you think.
For more tips on how to save a limb see our video – “Less than 60 Seconds to Save a Limb”