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Ulcerations

ULCERATIONS

What is it?

A foot ulcer is an open sore on the foot. A foot ulcer can be shallow and involves only the surface skin. however they can also be very deep.  A deep foot ulcer may be a hole that extends through the full thickness of the skin. It may involve tendons, bones and other deep structures.

More than any other group, people with diabetes have a particularly high risk of developing foot ulcers. This is because the long-term complications of diabetes often include neuropathy and circulatory problems. Without prompt and proper treatment, a foot ulcer may develop infection. If an infection occurs in an ulcer and is not treated right away, it can develop into:

  • An abscess (a pocket of pus)
  • A spreading infection of the skin and underlying fat (cellulitis)
  • A bone infection (osteomyelitis)
  • Gangrene. Gangrene is an area of dead, darkened body tissue caused by poor blood flow.

What can cause it?

Peripheral neuropathy.
This is nerve damage in the feet or lower legs. Diabetes is the most common cause of peripheral neuropathy. When nerves in the feet are damaged, they can no longer warn about pain or discomfort. When this happens, tight-fitting shoes can trigger a foot ulcer by rubbing on a part of the foot that has become numb.

People with peripheral neuropathy may not be able to feel when they’ve stepped on something sharp or when they have an irritating pebble in their shoes. They can injure their feet significantly and never know it, unless they examine their feet routinely for injury.

Many elderly people and diabetics with vision problems also can’t see their feet well enough to examine them for problems.

Circulatory problems.
Any illness that decreases circulation to the feet can cause foot ulcers. Less blood reaching  the feet deprives cells of oxygen. This makes the skin more vulnerable to injury, and it slows the foot’s ability to heal.

Poor circulation in the leg arteries is called peripheral artery disease. It also causes pain in the leg or buttock during walking. It is caused by atherosclerosis . This is a disease in which fatty deposits of cholesterol build up inside arteries.

Abnormalities in the bones or muscles of the feet.
Any condition that distorts the normal anatomy of the foot can lead to foot ulcers. This is particularly true if the foot is forced into shoes that don’t fit the foot’s altered shape. Examples are claw toes, bunions, and severe arthritis.

What can I do to treat it?

At Clarke Ventresca Foot & Orthotic Centres we work closely with the patient to provide the best wound care management. Our chiropodists will assess the possible causes and work hard with the patient to address these issues. The chiropodist may have to provide off-loading boots or shoes to alleviate pressure and often orthotics are needed for long term prevention.