Managing and treating diabetic foot ulcers

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What Is a diabetic foot ulcer?

A diabetic foot ulcer (DFU) is an open sore or wound that is usually located on the bottom of the foot. These occur in about 15 percent of patients with diabetes. They can become serious wounds, with up to 6% of those that develop DFUs needing to be hospitalised due to infection or other complications.

Diabetes is the leading cause of amputations in the lower limb, and approximately 20% of patients with diabetes who develop a foot ulcer will have an amputation. The good news is that these foot ulcers are preventable.

Who is at risk of developing a diabetic foot ulcer?

Anyone who has diabetes can develop a foot ulcer, especially if they use insulin, or have kidney or eye disease. Eye disease in those with diabetes indicates systemic damage from the disease. Being overweight and using alcohol or tobacco also play a role in the development of foot ulcers.

How do diabetic foot ulcers form?

A combination of factors is present when a foot ulcer forms, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as the overall duration of diabetes. Long-standing diabetes leads to a complete lack of ability to feel pain in the feet due to nerve damage. Nerve damage often can occur without pain, and one may not even be aware of the problem.

Why do we treat a diabetic foot ulcer?

It’s important to treat foot ulcers in patients with diabetes as soon as possible to reduce the risk of infection which can lead to amputation. Treating the ulcers will also improve the function and quality of life.

How do we treat diabetic foot ulcers?

The purpose of treatment is to obtain healing as soon as possible. The faster the healing of the wound, the lower the chance of an infection. The aim is:

  • to prevent infection,
  • to take the pressure off the area, called “off-loading,”
  • to remove dead skin and tissue, called “debridement,”
  • to treat the ulcer using the Trifectiv Plus Wound & Burn Care protocol and
  • to manage blood glucose and other health problems.

There are several crucial factors to manage to prevent an ulcer from becoming infected:

  • keep blood glucose levels under tight control,
  • keep the ulcer clean and bandaged,
  • cleanse the wound daily, following the Trifectiv Plus wound dressing protocol and
  • do not walk barefoot.

For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.” Devices that will reduce the pressure on the ulcer area will help to speed up the healing process. These include special shoes, crutches, or even a wheelchair.

The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. Keeping wounds covered and moist helps wounds heal faster, with a lower risk of infection.

Appropriate wound management includes the use of Trifectiv Plus-soaked gauze dressings, retained with a breathable bandage. The Trifectiv Plus protocol is a simple and effective wound care approach which is endorsed by Diabetes SA.

The Trifectiv Plus Wound & Burn Care Protocol

The Trifectiv Plus protocol is simple to follow:

  • Spray Trifectiv Plus Wound & Burn Care solution directly onto the wound and allow this to dry for a minute.
  • Wet some gauze (75 x 75 mm - clean, non-sterile) with Trifectiv Plus Wound & Burn Care and place this onto or into the ulcer.
  • Wrap the foot with a firm (not too tight) crepe bandage.
  • Replace daily.

The wet gauze will dry to “moist” overnight and when removed will pull any necrotic (dead) material from the ulcer, keeping the wound germ-free and stimulating healing.

If you have any questions about the treatment protocol please do contact us.

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