An ulceration is a full thickness wound that fails to heal unless some medical or surgical intervention is taken. An ulcer may become secondarily infected if not treated making it a more serious condition.
Symptoms of an ulcer is simply an open wound. If there is some neuropathy present, there may not be pain associated with it. If infected there may be redness, swelling, fevers, and chills along with it. Ulcers can go unnoticed if your feet are not inspected regularly.
Causes of an ulcer are varied. More commonly a patient presents with an ulcer that has some degree of neuropathy. There is usually a pressure point caused by either the bone structure, shoewear, or both.
Prevention is aimed at detecting pressure points before break down of the skin where ulcerations would most likely develop. This can be achieved with shoewear modifications, orthotics, padding, or strapping techniques.
Diagnosis of an ulceration is simply by an inspection of the foot. The underlying cause of having an ulcer needs to be addressed further for adequate treatment. X-rays are commonly used to evaluate the foot structure and determine any bone damage or disruption.
Podiatric Care is aimed at treating the ulcer as well as the cause of having the ulcer. Ulcerations are usually treated with frequent dressing changes and debridement (cutting of tissue). Necrotic, or dead tissue surrounding an ulcer needs to be removed for the healing process of the skin to continue. These can become hard to heal if the blood flow to the area is inadequate which again happens in patients with diabetes frequently. A bloody fresh base to an ulcer is usually a good sign showing that blood flow is present to help heal the wound. Some medications, creams, gels, or powders are also frequently applied to promote growth in the wound area. If infected your physician may place you on antibiotics and if more severe may need to place you into the hospital for a period of time. Ulcers can become seriously infected spreading to the tissue and bone. If infection leads to the bone this is called osteomyelitis.
Surgery may be indicated for ulcerations to treat underlying bone conditions or for a more extensive debridement.