The First Steps to Getting a Diabetic Foot Ulcer to Heal

When you discover a diabetic foot ulcer, it's a scary situation. You suddenly notice a hole in the bottom of your foot. My name is Dr. Andrew Schneider and I'm a podiatrist in Houston, TX. A diabetic foot ulcer is important to address immediately. How you first treat a diabetic old foot ulcer may dictate the speed in which it is going to heal. In today's video I'm going to discuss the first steps you should take when a diabetic foot ulcer is discovered.

I recommend that all of my diabetic patients begin a nightly routine of inspecting their feet. This is an essential way to make sure their feet stay
healthy. What are you looking for during these inspections? You're looking for anything that wasn't there yesterday. For instance, be aware of any new callus, blister, erosion, sore area of bleeding or pus, and especially the start of a diabetic foot ulcer.

A diabetic foot ulcer, for lack of a better description, is a hole in the bottom of your foot. It can become infected. The infection can travel to the bone. This puts your foot at risk for amputation. My job is to prevent that from happening. That's why the first thing you do when you discover a diabetic foot ulcer is to contact your podiatrist.

In my practice, the discovery of a diabetic foot ulcer is a medical emergency. You call and say, "I'm diabetic. And I think I have a problem." and no matter what our day looks like we get you in. Once at the office, we'll do some assessments on the foot ulcer. We'll likely take an x-ray to make sure the bone isn't involved and to make sure there's no damaging gasses in the tissue. We may also do a circulation test to make sure you have enough blood flow to heal the ulcer. I'll remove the unhealthy tissue of the foot ulcer to be able to see it's true borders in depth. This is a process called debridement.

At this point. I'll have a good idea if the wound is infected or not. This is essential to be able to offer the proper treatment. Even if the wound is not infected, I may still prescribe a course of antibiotics to ensure you're clear of any infection. I may also swab the wound to send material to the lab, to check for infection as well.

Now it's time to decide how to start the wound on the path to healing. A common mistake I see is to either not dress the wound or to treat it like a cut. Sometimes you may be told just to put a topical antibiotic on it. Whether prescribed or over the counter, this is the wrong approach. We want to apply a wound dressing that will keep an ideal environment for the ulcer to heal. We also want to use dressing that will promote the tissue to
heal. a topical antibiotic, or a cream such as Silvadene, do not meet these
criteria. The good news is that there are a tremendous number of wound care products on the market designed to heal your foot ulcer. Some of these wound dressings are topical gels or ointments that are easily applied to the wound at home. These are usually prescribed through your regular pharmacy.

There are other types of dressings that promote the healing of a diabetic foot ulcer. I change to these dressings. If I don't see the wound progressing to become closed, I don't like to see a wound stagnating. These dressings fall into three categories, Collagen, Alginates, and Foams.

Collagen is the most abundant protein in your body. It's involved with all aspects of wound healing. Using dressing embedded with collagen encourages the body to form new collagen fibers and support the growth of new tissue. Collagen dressings most often come in sheets and in powder form.

For wounds that may be draining, I'd consider using an alginate dressing. An alginate dressing is formed from seaweed and is capable of absorbing moisture. When moisture interacts with the dressing, it forms into a gel that supports the healing of the foot ulcer because it requires moisture to
be reactive. It's not used on dry wounds.

The final category of conventional wound products are foams. Foams are indicated for wounds that have even heavier drainage. Sometimes
they're used as a primary dressing directly on the wound. Other times, they're used as a secondary dressing to absorb more moisture if necessary.

These are just the broad categories. Within each is a tremendous number of products that are available. There's no one-size-fits all solution for a
diabetic foot ulcer. If these aren't providing results, there's more that can be done. In next week's video, I'll discuss more advanced dressings for diabetic foot ulcers.

#DiabeticFootUlcer #FootUlcerTreatment #DFU

00:00 Introduction
01:05 Why you should inspect your feet nightly if you are diabetic
01:35 What is a diabetic foot ulcer?
02:15 How a diabetic foot ulcer is assessed
03:46 Choosing the right wound dressing for your diabetic foot ulcer
06:16 How to connect with Houston Podiatrist

[michaeljackson]

I have been treated successfully for a foot ulcer, passed healed about 6 weeks ago. 1st thing, check for infection. Second, as soon as possible, get your numbers in check. I used Berberine and not a pharmaceutical and it really works. Next, I used Vegesorb to maintain my feet to ensure no calluses. Luckily, I had plenty of blood flow even though I have neuropathy. Finally get it done in a country like mine, (Australia) because I had multiple visits to my GP, several visits to 2 different critical foot clinics at local hospitals, 3 x Xrays + an MRI, finally a moon boot to keep the sole free of pressure. And why in Australia? Because I paid not a single cent for the treatment from start to finish. Universal health care? Any day of the week thank you!

[sandralang]

Thank you so much for this video. I wish my husband had seen this years ago. He is recovering from wounds on both feet which have taken over a year to heal. It has been a difficult struggle. Thank you for educating diabetics and offering hope.

[SloopyDog]

For the last three years, I have suffered from a large amount of hard skin on the bottom of my foot. I kept telling the podiatrist it was hard to walk on and very painful. The podiatrist just ignored me and she only removed a small amount of the hard skin so it was still painful and painful to walk on. She also neglected other painful sores on my feet. I eventually put a complaint at my doctor's practice and my doctor sent me to a local hospital to see a podiatrist. She was shocked when she saw the poor condition my feet were in and when she cleaned out the hard skin found a very large and infected ulcer, she also found ingrowing toenails and several other problems. Podiatry has to be done properly or the consequences can be the loss of a foot or an amputation of the infected leg.

[BaileyC]

My dad has had an ulcer on his big toe for 2 years. It got infected last year and he went into the hospital for 3 months with kidney failure due to the infection. It healed then came back. All the docs tell him is to have the toe removed, but he has a friend who had his toe removed then more toes then half his foot. My dad knows that when they start cutting it will never end till they take his whole leg. He is trying to heal it he is 50 and doesn't want to wind up useless before he is old.

[anthonyluna]

I got my ulcers from a hot pad that I put on my right foot because my foot is numb I didn't feel the third degrees burns that occurred when I took off the heat pad I had three skin boils on my foot. It's been three months later and I'm barely healing, no rotting smell of death, no black meat just drainage and a cheesy smell but it's healing well. Healthy tissue growth and I'm using silverzene plus calcium alginate it's been working well. I have no health insurance so I listen to this man and he has helped me tremendously. I'm planning to move to Texas because of the State government it conforms to my beliefs and I planned to live there.

[karenyoung]

I am living on Jamaica and I'm glad I stumbled on your video. It makes me more able to deal with my diabetic son and his foot ulcer. He's currently in hospital.

[Warrior_of_light]

Ok, went to doctor as I had what I thought was a blister- it was not but all is good- they just had to cut it off and now I am healing. But thanks for this information, did not realize how important feet really are if you have diabetes.

[oreally]

I have one now. I've had them before. This one is draining. Calling my Dr. Monday.

[carolferguson]

Why thank you so very much. I finally went to the doctor for other problems & took my shoes off. Now I will see wound care Monday. You seem very kind. I appreciate your putting this information on YouTube. I wanted to have an idea of what I was going to experience. I’m north of Atlanta in a small town🤗

[TeachersDaily]

Hi doc, what is the proper dressing of blisters that popped out.

[mlingeshashree]

Thank you for your advice. Taking your advice to help my brother recover.

[keshiasamuel]

Thank you so much for sharing this video, it's very helpful.

[vkorchnoifan]

I have a foot ulcer. I am diabetic. I am using TopCare triple antibiotic ointment, aquaphor ointment and therahoney. I am using a big bandage to put all these gels on and medical tape to bond. I am doing this every other day as well as changing socks eveery day. I used to walk every day but I now quit and try to walk without using the heel.

[arnelarsen]

I’m amazed no mention of treating wound with ozone. Cleaning wound with ozonated saline, topical ozonated oil and limb bagging with ozone. Secondly restore blood circulation using EWOT if patient can use an exercise bike.

[saddamalio]

Example of antibiotics ointments applied to the wound especially gangrenous i apply Clotrimazole, , Xtraderm

[drd]

Can u use staples or vetabond ? Leaving a small opening to drain in a non diabetic pressure sores?

[figmo]

My BF has been dealing with a diabetic foot ulcer since the Saturday before Labor Day. It's taking forever to heal. The podiatrists he's seeing have just had him dress the wound with dry gauze.

I'm hoping to learn more about what we can do for him. I don't have much faith in his podiatry team (he's got Kaiser HMO), as they seem more eager to lop things off than to treat anything.

[mlingeshashree]

My brother, insulin dependent, had triple bypass open heart surgery few years ago, has a diabetic ulcer, L foot. Getting collagen dressing since last August. Healing is v slow...
He has a fallen arch too, which is making it v slow to heal.

[peaked_aussie]

Thank you for this information. I am curious to know what your opinion is of silver wound dressing?

[helainegardner]

Why do people with diabetes get their toes cut off.