November 13, 2003
Complications
Question from Kennewick, Washington, USA:
In the past year, my dad has developed two ulcers due to his diabetes, one of which resulted in the amputation of his big toe. Since then, he has been seeing doctors regularly and has been prescribed some extra-depth shoes and sole inserts to keep pressure off of an existing ulcer that is still in recovery. However, he recently noticed a second ulcer forming. My family tries to convince him to stay off his feet as much as possible, but he is stubborn, only wears his shoes 50-75% of the time, and still wants to stay on his feet. His doctors only seem to give him recommendations to follow rather than being very adamant as to what treatment he should be following. I have several questions:
Besides diet and exercise, what can be done to help the ulcers heal?
Should he be staying off his feet as much as possible?
Would foot massages and/or pedicures help with circulation and accelerate healing?
What types of topical treatments should he be using, if any?
Should his foot doctor put him back on antibiotics?
Answer:
According to your message, it appears that your father should be under the care of a wound care specialist. There are many new modalities for treatment and prevention of ulcers. Growth factors, various conservative pads and orthotics are available. Additionally, your father should have tight control of his blood glucoses in order to prevent reoccurrence. I would consider talking to your father’s physician or contacting the local hospital to see if they have a wound care center that can help.
AS
