In most cases, when we get minor cuts or scrapes, we stick a plaster on the affected area, and don’t dwell on it much knowing that it will heal by itself. Small cuts pose no threat as we can rely on the normal functioning of our body to take over and begin the wound healing process. The wound heals within a few days with minimal intervention and does not cause any lasting harm. However, this is not the case when it comes to diabetic patients. Diabetics are more vulnerable to wounds and ulcers in comparison to healthy people, especially when it comes to wounds or ulcers on the foot. Diabetes is a chronic disease that interrupts the body’s natural healing process. This means that even small wounds can get overrun with infection and turn into larger problems.

How wound healing works in diabetics

Our skin acts as a barrier between outside germs and bacteria. When an abrasion forms on the skin, the barrier is broken and the wound is left exposed. If harmful bacteria enters the wound at this stage, it has the potential to cause an infection and further complications. In healthy bodies, white blood cells rush to the wound site to destroy bacteria and protect the body from infection. Only after this stage does the tissue regrowth stage begin and the wound gets patched up. 

In diabetics, the body is unable to produce or use a hormone called insulin. Because of this, the blood sugar level increases which has adverse effects on wound healing. When blood sugar levels rise, they impair the functioning of white blood cells (WBCs). WBCs are imperative for the functioning of the immune system, and without them the body is unable to fight off infection efficiently.   

If diabetes is not kept under control, it affects blood circulation as well. Slower blood circulation hampers the healing process of the wound as the nutrient supply to the wound site slows down. Oxygenation of the wound site is also vital in the healing process, and slower blood circulation means slower oxygenation. Another risk factor is that diabetes can cause neuropathy (nerve damage) which is the numbing of sensation in parts of the body. Due to this, the diabetic patient might not realize that they have sustained an injury as they will not feel it.

Common diabetic wounds:

Wounds on the feet pose the biggest risk when it comes to diabetic wounds. This is because neuropathy affects the feet first and it’s highly possible that the patient does not notice a wound forming due to the loss of feeling.
  1. Foot Ulcers

    Foot ulcers are open wounds or sores that form on the feet. They are the most common and most high-risk wounds for diabetics. In severe cases, the diabetic wound infection takes over the entire foot, and amputation may be required. Since diabetics suffer from neuropathy, pain is not the first symptom that crops up when they get a foot ulcer. Because of this, they may not notice it until the wound has deteriorated and become infected. Here are some of the signs that you will notice if your foot ulcer has become infected:

    • Excessive pus and fluid discharge from the wound
    • Foot wound not healing as fast as usual
    • Swelling and redness around the wound
    • A strange odour coming from your foot
    • In serious wounds, dead black tissue called eschar will start to surround the wound

    If you happen to display any of these signs, consult a doctor immediately. Your doctor will assess the severity of the wound and recommend a treatment plan accordingly. Usually, treating a diabetic wound ulcer includes the following steps:

    1. Off-loading: If weight or pressure is applied to the ulcer it will make it worse and expand the wound. This is why your doctor will advise you to stay off your feet as much as possible. You can wear foot braces, casts, compression wraps or special shoes to protect your ulcer.
    2. Debridement: Debridement is the process of removal of dead, damaged or infected tissue from the wound. This helps to curb the infection by stopping it from spreading to healthy tissue.
    3. Medication: Your doctor may prescribe antibiotics or other medication to fight off infection and heal the wound quicker. Make sure to follow your prescription diligently to prevent the situation from getting worse.

    In the case of severe infections, if there is no other option available, amputation may be required. The extent of amputation depends on the severity of the wound and the progression of the infection. Remember, diabetic foot wounds are easily treatable in the early stages. Staying vigilant and on top of your health can help avert adversities.

  2. Foot Corns

    Foot corns are hardened layers of skin that form due to prolonged friction or pressure. Anybody can get a foot corn, but it is particularly risky for diabetic patients. This is because the usual treatments for foot corns cannot be used by a diabetic patient. Usually, foot corns are treated by either removing them with a pumice stone or a foot file, this is harmful for the following reasons:

    • Pumice stones: Pumice stones have an abrasive surface used to file off dead skin. Since they are not sterile, it could be an entryway for infection to enter your body. Furthermore, diabetic patients who suffer from neuropathy might scrape off excess skin without realizing it, which could lead to a foot ulcer.

    • Foot files: Foot files are another harsh device used to scrape away corns and callouses. They are risky for the same reasons as a pumice stone, but the added risk factor is that foot files are usually made of some kind of metal. If a rusted part of a foot file scrapes against your skin, it provides a direct entryway for bacteria to inhibit the cut and spread infection.

General tips to follow if you are a diabetic:

Factoring in the increased risk of infection, diabetic patients need to be very careful while caring for their wounds. As they say, prevention is better than cure. Remember to:

  •  Always wear comfortable footwear
  • Do not pick or itch at scabs or dry skin
  • Make sure to moisturize so that your skin stays strong and doesn’t flake
  • Be careful not to snip your skin when you’re trimming your toenails
  • Wash and inspect your feet daily
  • Stay on top of your blood sugar levels and ensure optimum diabetic care

A wound care checklist for diabetics:

Wounds are inevitable but we should do all we can to prevent them when possible. If you have sustained a cut in any part of your body, follow the appropriate wound care procedure immediately. Here are the steps to follow to properly clean and care for a diabetic wound:

  1. Clean the wound with saline solution or warm water to clear out skin debris and dirt
  2. Apply an antibiotic ointment for faster healing time
  3. Wrap a clean gauze pad around the wound or use a plaster
  4. Follow your diabetes treatment regime strictly and keep a check on your blood sugar levels to ensure there’s no alarming rise
  5. Don’t put unnecessary pressure on the wound

Keeping all of these factors in mind can help you to correctly treat your diabetic wounds and ulcers and stay free from infection. Read More Here: How To Treat a Foot Corn Effectively