Does My Small Diabetic Foot Ulcer Require Expert Wound Care? 

November is American Diabetes Month®, so it's a good time to highlight a critical issue that often slips under the radar — diabetic foot ulcers.

Dr. Matthew Cerniglia at Ankle and Foot Institute of Texas in Fort Worth is an expert podiatrist with years of experience in diabetic foot care and specialized wound care. He can examine your feet regularly, checking for signs of diabetic foot ulcers and treating them — even small ones — before they progress into big problems. 

Here, he explains why diabetes poses a problem for your feet, when to seek help, and how we treat diabetic foot ulcers.

Diabetes and your feet

Diabetes can make any wound more severe than it might seem on the surface because elevated blood sugar levels slow the healing process and increase your risk of infection. Your feet, however, are in particular danger because they’re the farthest from your heart, so circulation is weaker — and without good circulation, your wound won’t heal.

About 60% of people with diabetes also have neuropathy — a condition that reduces your ability to feel pain and notice wounds or sores. Small foot wounds can quickly escalate into ulcers, leading to severe complications, including lower limb amputations. 

Second only to traumatic injury, diabetes is the leading cause of amputations in the United States, and about 5% of diabetics with foot ulcers face this fate. So it's crucial to recognize the signs of a problematic ulcer and seek Dr. Cerniglia’s care promptly.

Warning signs of a worsening ulcer and when to call a doctor

Even a small ulcer can quickly develop into a big problem, so Dr. Cerniglia urges you to make an appointment as soon as you notice one. However, if you see any of the following warning signs, call us immediately.

• Redness could indicate inflammation or infection
• Increased warmth or swelling suggests your body is fighting an infection
• Extra drainage, pus, or odor indicates an infection
• Fever or chills often signal a more serious issue
• Increased pain or firmness suggests the wound isn’t healing correctly

If your wound is white, blue, or black, it indicates a lack of healthy blood flow, and you should seek urgent medical care. 

How we treat diabetic foot ulcers

Prompt, professional treatment can save your foot. Depending on the type and severity of your diabetic foot ulcer, Dr. Cerniglia uses various techniques to sterilize the wound and facilitate healing.

Debridement

Debridement is a critical first step in treating diabetic foot ulcers. This process involves removing dead skin and tissue from your wound, promoting faster healing and reducing the risk of infection. There are several types of debridement:

• Sharp debridement involves scalpels, scissors, or other medical instruments to remove dead tissue
• Autolytic debridement utilizes your body's enzymes and moisture to break down dead tissue
• Enzymatic debridement is a topical treatment that breaks down dead tissue

Dr. Cerniglia determines which type of debridement to use based on your wound’s characteristics.

Medication

Medication manages pain and prevents or treats infection. Dr. Cerniglia may prescribe antibiotics if you have an infected ulcer. Studies show that antidepressants, such as amitriptyline, nortriptyline, and venlafaxine, can also manage neuropathic pain associated with diabetic foot ulcers.

Offloading

Offloading relieves pressure from the affected area to promote healing. Methods include:

• Total-contact casts to distribute weight evenly across the foot
• Removable cast walkers to reduce pressure on your foot 
• “Half shoes,” used when the ulcer is located on the end of the foot or toes

These orthotic devices make walking more comfortable as your diabetic ulcer heals.

Skin grafts

In some cases, particularly for chronic diabetic foot ulcers, Dr. Cerniglia may perform a skin graft. This procedure involves transplanting healthy skin from another part of your body or using a skin substitute to cover your wound, promoting healing and preventing further complications.

When you see a small diabetic foot ulcer — act fast

We can’t overemphasize the importance of expert care when dealing with diabetic foot ulcers, and we encourage you to call us if you notice any of the above warning signs or have concerns about your foot health. 

Remember, American Diabetes Month isn’t just about raising awareness; it’s also about taking action. If you or a loved one is struggling with diabetes and have concerns about foot ulcers, call Ankle and Foot Institute of Texas or request an appointment online. Your feet are in good hands with us.