Wound Care In Diabetics

By Dr. Katherine A. Sahm, M.D., F.A.C.S. 

When a person has high glucose levels they may experience difficulty healing. Many people with diabetes experience unfortunate but unavoidable minor wounds, cuts or burns. For people with high blood sugars they can lead to serious health issues.

Many people with diabetes develop wounds that are slow to heal, don’t heal well or never heal. The feet are one of the most common places of injury for a diabetic. A small wound on the foot can quickly develop into a foot ulcer.

When your blood sugar is high it prevents oxygen from reaching cells, it prevents your immune system from functioning effectively and it increase inflammation in the body’s cells. All of which are negative factors for wound healing. 

Foot ulcers can become problematic and serious if left untreated. Between 14-24% of people who have diabetes and develop a foot ulcer will end up having a lower limb amputation.

If you are a diabetic you are twice as likely to develop peripheral vascular disease. This is a condition involving your circulation that causes blood vessels to narrow and reduces blood flow to your limbs. This makes healing open areas to your lower extremities more difficult.

This is the reason that it is important for regular self-checks and monitoring of any wounds closely. If wounds are caught early it is a way to decrease your risk of complications.

Because as a diabetic your immune system is compromised, you are more at risk for infection. If you have a wound; good nutrition, and having the correct amount of protein and vitamin C is important as well. Diet can directly affect your blood sugars, so maintaining proper nutrition is important. If you can maintain healthy glucose levels, you are more likely to avoid wounds and heal more quickly if a wound occurs. 

If you are a diabetic and have lower extremity or foot wounds there are a few things that you can do to help the healing process along. 

• Do daily self-checks of the wounds – early detection is important in avoiding infections and other complications. 
• Look at new wounds regularly especially on your feet. Make certain to check between your toes as well and seek physician assistance if the wound appears to be increasing in size or changing in color.
• Keep pressure off of the area with the wound. Any increased pressure can cause damage to the skin and often leads to a deeper wound or ulcer.
• You may need to see a physician to remove any of the dead skin cells from the wound or necrosis. Any necrosis can promote bacteria and other toxins increasing the chances for infection of the tissue. Necrotic tissue left on the wound also does not allow for inspection of the underlying tissue. A physician who understands wound care can assist with removal of the tissue if it is deemed appropriate for the type of wound you have. 
• If you have an existing wound, keeping a clean dressing or bandage can reduce bacteria and maintain proper moisture levels that are required for wound healing. Physicians often order special wound dressings (bandages) to treat your particular type of wound. Leaving such wounds open to air is not appropriate and often misunderstood by patients. Interruption of the wound bed or the wound bed getting cold is contraindicated and will negatively effect healing. 

When to seek the care of a Physician regarding your wound:

You should see a doctor if your symptoms worsen or you have pain, swelling, drainage from the wound, increase in size or if you think you have a wound and can’t see it on your lower foot or leg.

If you are a diabetic, any insult to your skin or break in your skin is a need for concern. If you are not certain about a wound, you should see a physician. The physician can assess the wound and advise you on how to achieve the best care for it. Receiving prompt, appropriate treatment is the key to prevention of complications.

Dr. Sahm is certified in wound care and treats many patients with diabetic foot ulcers and peripheral vascular disease.

Dr. Sahm is certified in wound care and treats many patients with diabetic foot ulcers and peripheral vascular disease. Her office is located at 1401 Foulk Road, Suite 207 in Foulk Stone Plaza. If you need wound care or an appointment to have a wound evaluated you can call 302-475-4900 or visit christianacare.org/surgery.