Foot Ulcers

An ulcer is a medical term for an open sore. Foot ulcers are more common in diabetics and the elderly, and can take from days to years to heal depending on the cause and the health of the person. Most ulcers heal in time if dressed and cared for appropriately. However, on occasions they can deteriorate and lead to severe infection, gangrene or amputation.

Foot Ulcer in someone with Rheumatoid Arthritis

What Causes a foot ulcers?

Foot Ulcers are often caused by one or a combination of the following things:

• A loss of sensation in the feet - Peripheral Neuropathy
• Poor circulation; such as from diabetes or smoking
  
• Ill fitting footwear
  
• Injury
  
• Walking Barefoot
  
• Poor foot hygiene
  
• Foot Deformity
• Pressure

Foot deformity, reduced blood supply or nerve supply to the feet can increase the risk of foot ulcers. 

How are Foot Ulcers Treated?

Following an assessment, a plan of treatment will be agreed between yourself and your podiatrist / doctor / nurse. This may include:
1. Regular dressing of your ulcer – there are many different kinds of ulcer dressings, your podiatrist / nurse may suggest the best one for you.
2. Debridement when appropriate. Debridement is a term used to describe the removal of hard skin, or dead or infected tissue and is not normally painful.
Benefits of debridement: 
·                It reveals the full size of the ulcer.
·                Reduces pressure on the edge of the ulcer.
·                Reduces the risk of trapped infection.
3. Pressure relief is an important part of your treatment plan. Any pressure exerted on a pressure ulcer either from footwear or walking may slow down the healing process.
There are many different ways of taking pressure off your ulcer. You and your podiatrist can decide together which would be best for you. 

 

 

Will I need Special Tests?

If the cause of the ulcer is unknown or if there is suspected infection your podiatrist or doctor may refer you for more tests. These may include:

• A swab from the ulcer to help identify bacteria which may be causing infection 
• Circulation tests on your legs and feet
• Sensation testing 
  
• Blood tests
  
• X-ray or ultrasound scans to help determine information about the ulcer such as its depth or whether or not infection is in the bone etc

Do's and Don'ts of Foot Ulcers

• Do keep your legs elevated if advised by your Podiatrist.
  
• Do keep your blood glucose levels well controlled (if you are diabetic). This is very important to help healing take place
  
• Do give up smoking if possible– ask your doctor, nurse or podiatrist for advice
  
• Do keep your dressing in place and keep it dry. If you have problems with your dressing, contact your podiatrist, doctor or nurse
  
• Do use any special footwear / insoles you have been provided with by your Podiatrist
• Don’t sit or stand in one position for a long time if you have been advised against this
  
• Don’t sit too close to the fire or heater
  
• Don’t stop taking antibiotics in the middle of a course as it encourages the growth of super bugs. Always consult your doctor first.

Remember … if you notice any change to your foot such as:
·                Swelling
·                Redness
·                Increase in pain
·                Increase in the amount of fluid coming from the ulcer
·                If you develop hot or cold sweats or flu-like symptoms 
Contact your podiatrist, nurse or GP immediately as these symptoms may suggest infection is present or that further treatment may be required.

 

 

Common Questions

Do I need to take antibiotics? Only if your ulcer is infected. You will receive individual advice if you develop infection.
How long do I need to take antibiotics for? 7 days to several months depending on what type of foot infection is present and how deep the infection is. This will often be arranged by your GP.

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