An ulcer is a type of skin sore that often occurs on the feet, toes or legs. It most commonly occurs in people who have diabetes or neuropathy. Diabetes can cause nerve and blood vessel damage in the lower extremities which can reduce sensation to pain and injury. Nerve damage occurs in about half of the people with diabetes and commonly affects the nerves in the feet and legs. Some people experience burning, tingling, pain or numbness. The nerve damage can eventually progress to complete lack of sensation and numbness.

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The lifetime risk of developing a foot ulcer for a person with diabetes is estimated to be between 19 and 34% with a recurrence rate of 40% within 5-7 bilateral year and 65% within 5 years. Combination of reduced sensation and poor wound healing increases the risk of infection which can lead to the development of ulcers in the lower extremities.

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Signs of a worsening ulcer may include but are not limited to:

– Purulence or drainage
– Warmth, redness or swelling to the area
– Increased pain
– Fever, nausea and/or chills
– Odor
– Change in consistency of wound bed

You should call your healthcare provider if you have any signs of infection or concerns for worsening of your ulceration.

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Treatment

Ulcerations especially when related to diabetes can significantly affect the quality of life, including physical, financial and psychological impacts. A multidisciplinary approach to preventing and treating ulcerations is necessary and may include your primary care provider, endocrinologist, podiatrist, vascular surgeon and infectious disease specialist. Ulcerations left untreated or even delayed care can result in infection, cellulitis, osteomyelitis(bone infection), amputation of digit and sometimes extremity.

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Ulcerations should be routinely treated with debridement and wound care but resolution of the ulceration routinely requires offloading, activity modifications, shoe modifications and sometimes surgery.

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Our surgeons are board qualified by the American Board of Foot and Ankle Surgery and can provide specific and unique treatment options to treat and prevent ulcerations. There are many percutaneous techniques as well as minimally invasive surgical options to help alleviate and prevent future ulcerations.

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