Diabetic wounds, often on the feet and lower limbs, are more common in those with neuropathy or magnesium deficiency. Proper circulation is vital for healing, and treatment includes removing infected tissue and infection control. In severe cases, amputation may be necessary.
Doctors don’t fully understand why some patients with diabetes will eventually develop a diabetic wound, but it’s more common in those with neuropathy. Diabetic wounds usually present in the form of an ulcer, usually on the feet and lower limbs. This could be partially caused by neuropathy in the feet, which can cause tingling, burning, and eventually a complete loss of feeling in one or both feet. When feeling is lost, patients often cannot tell when a foot has been cut, punctured, or even broken. While this is a theory, it has also been found that the vast majority of diabetic wound sufferers are magnesium deficient. Supplements or eating magnesium-rich foods can offer moderate relief.
Before a diabetic wound can be treated effectively, doctors must first determine the extent to which the area has been damaged. Blood flow to the affected area is tested because proper circulation is vital for healing. X-rays or MRIs may also be taken to determine if the wound has spread beyond the surface to affect muscle or bone tissue. Knowing these things beforehand can help determine how well a wound can heal. In some cases, the wound may not be curable and the limb will need to be amputated.
Treatment for diabetic wounds includes removing any infected or dead tissue from the area and cleaning it with a saline solution. The wound is then covered to prevent contamination or infection from outside sources. Almost any type of dressing can be used to cover a diabetic wound, but specialized dressings with certain medications and adjuncts may be used for wounds that do not respond well to treatment.
Patients are also required to keep weight off the affected area as much as possible. Depending on the extent of the injury, complete bed rest may be required. For less serious injuries, the patient may need to use a wheelchair, crutches, or other methods to keep weight off the injured area. Total contact casts (TCC) can also be used because they take almost all the pressure off the wound and have an excellent success rate for healing. However, they are time consuming to wear and some clinicians prefer a more easily removable option for frequent wound inspections.
Infection control must be strictly monitored to avoid serious complications and amputations. For most patients, getting an infection is the most dangerous circumstance of having a diabetic wound and is the most likely factor leading to amputation and longer healing times. The wound must be kept clean and free from contaminants. When infections do occur, a broad-based antibiotic should be given to cover any pathogens that may have infected the wound. Very serious infections may require the administration of intravenous drugs.
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