Wound on the foot and ankle

June is Wound Healing Awareness Month. Wounds are sores or cuts in the skin also known as ulcers. Living with a wound that just won’t heal can be frustrating, scary and potentially serious. A foot ulcer can be prone to infection, which may become severe and lead to amputations. Seeing a wound specialist will help speed up healing and improve your quality of life.

There are different types of wounds based on the cause and location of the wound on the body. Let’s look at why foot ulcers sometimes develop, what you can do to help prevent treat them.

Wound types

Ulcers can be acute and heal quickly, meaning they take a long time to heal or do not heal at all. There are several types of chronic wounds. The most common types include:

• Diabetic foot ulcers.

• Arterial ulcers due to poor blood flow to the feet.

• Pressure ulcers.

• Venous ulcers.

• Traumatic wounds.

• Non-healing surgical wounds.

Why some people ARE prone to foot ulcers

Foot and leg ulcers occur for several reasons. They are more common if you have diabetes, reduced feeling to your feet, if your diabetes is not well controlled and if you have poor blood flow to the feet. All these factors increase your risk of developing a diabetic foot ulcer. The risk of this occurring increases the longer you have diabetes and the older you are.

Arterial and venous ulcers happen because the blood vessels are not working well. With arterial ulcers there is not enough blood flow to the feet leading to ischemia, pain and gangrene while venous ulcers result from malfunctioning veins leading to swelling and heaviness in the legs. Pressure ulcers also called “bed sores” are caused by constant pressure on the skin that cause them to break down. On the feet these occur on the heels and over areas where there is prominent bone. Traumatic wounds and non-healing surgical wounds are self-explanatory and usually don’t last as long as the other chronic wounds.

Are foot ulcers
serious?

Although foot ulcers can be serious, they usually respond well to treatment. However, foot ulcers can become worse and can take a long time to heal if you have diabetes, particularly if your circulation is not good. Having an ulcer can also increase the risk of an infection in the ulcer. Sometimes it can lead to more serious problems such as gangrene and even amputation.

What to do if you develop a foot ulcer

If you have an ulcer or sore on your feet or lower leg see your podiatrist or primary doctor as soon as possible. They will examine your feet and treat the ulcer and aim to dress and protect the ulcer, to prevent or treat any infection and also to help your skin to heal. The ulcer should be covered with a protective dressing. Do not leave the wound open, it slows wound healing.

According to the type of ulcer, the podiatrist may need to remove any hard skin that prevents the diabetic foot ulcer from healing. Also, depending on the site and size of the ulcer, they may protect it from further injury by using padding to take the pressure off the area. You will also need to stay off your feet, wear special shoes or have a cast made for your foot to keep the pressure off the ulcer. If the ulcer is infected, antibiotics will be ordered. If there is an abscess, a small operation may be needed to drain pus or other drainage from the foot.

The person with a venous ulcer will need to wear compression dressing or hoses to help treat the ulcer. If it is an arterial ulcer you will be sent to see the vascular doctor for them to check out your blood flow to the feet. Sometimes you may require an operation to open up the arteries. Pressure ulcers will need to be offloaded to take the pressure off the area and allow the ulcer to heal.

The podiatrist may order an x-ray or other imaging scans of your foot to make sure the bones have not been affected by the ulcer. Many foot ulcers will heal with treatment however, they may take a long time to heal. In some cases, without going to the doctor, the ulcer may worsen, become badly infected, may not heal and require surgery to clean it up. Sometimes infection can spread to nearby bones or joints, which can be difficult to clear, even with a long course of antibiotics. Occasionally, parts of the foot or leg may be at risk for an amputation.

When to see the doctor

It is best to see the doctor right away if you have a wound or suspect a wound may develop. For people with diabetes you may notice an area with heavy callous (hard skin) especially if it is redish, blue or brown under the callous. For people with venous ulcers, pain and swelling in the leg, change in the color of the skin just above the ankle and sometimes small blisters on the leg may be seen. For arterial ulcers pain is worse, especially at night when the foot is elevated. Sometimes the pain is better when the foot hangs of the side of the bed. Any ulcer on the toes or foot with this type of pain may be ischemic, it may turn bluish or black and begin to dry up. Pressure ulcers are most common on the heels and sides of the foot or ankle where bone may be prominent.

Nutrition and wound healing

Many people with wounds may be elderly, have diabetes, and be overweight or even obese. Besides having a skin ulcer caused by diabetes, bad veins, low blood flow or persistent pressure these people often have unrecognized signs and symptoms of malnutrition. The doctor will check the health status of the people by asking questions about nutrition and their eating habits and check labs. They may also be referred to a nutritionist for a more complete assessment and counseling. It is important for the person with wounds to eat a balanced diet with good quality protein, more veggies and fruits and less processed foods and sugar. Adequate protein and vitamins and minerals like vitamin C are needed for wound healing because they help repair and make new skin. If you have an ulcer or wound to your feet or legs, it’s time to see the podiatrist.

• For more information on foot conditions, visit www.apma.org, healthcentral.com, or email us at foothealth242@gmail.com. To see a podiatrist, visit Bahamas Foot Centre, Rosetta Street, or telephone 325-2996 for an appointment at Bahamas Surgical Associates Centre, Hilltop Medical, or call 394-5820 for an appointment. You can also visit Lucayan Medical Centre in Freeport, Grand Bahama, or telephone 373-7400 for an appointment. 

The post Wound on the foot and ankle appeared first on The Nassau Guardian.

source https://thenassauguardian.com/wound-on-the-foot-and-ankle/