Ulcer causes and treatment methods

People who have diabetes often get foot ulcers due to ischemia, neuropathy or both. The primary initiating injury may be caused due to sharp thermal or mechanical shock. It may also be due to the continuous application of mechanical stress. Patients suffering from limb ischemia must be checked by a vascular surgeon. The seriousness of the disorder must be taken care of, and the requirement of treatments like stenting, bypass or angioplasty must also be considered.

When contamination worsens a foot ulcer, it can be limb-threatening as well as life-threatening depending on the degree of infection. Infection must be detected clinically, but the causative pathogens can only be found out using wound culture. Specimens of tissues are preferred to wound swabs for culture. In this situation, priority must be given to healing the infection and not the wound. Antimicrobial therapy must be suggested based on results from wound culture.

The primary treatment of the ulcer must start from the removal of mechanical load from the affected area. Podoscan is one of the most effective tests to detect the pressure distribution over the affected area. It takes about six weeks to heal Neuropathic ulcers with complete contact casting. This method removes the pressure from the ulcer site and gives comfort to the patient. The accomplishment of other techniques to off-loading depends entirely on the patients’ capability to endure pain and the efficiency of the method applied.

Surgical treatment of ulcers may include processes like reconstruction, tenotomy, removal of bony protrusions or tendon lengthening. However, these methods may have complicated side effects like secondary ulceration. The rate of recurrence of ulcers is also quite high, but if proper education is given to the patients, it can be minimized. Regular foot care and using post healing footwears can be effective.