|  | Conditions Treatments | Diabetes

Diabetic Ulcer Treatments

Diabetic ulcers (open wounds) relate to both neuropathy, which causes decreased sensation that may result in undetected injury, and poor circulation from blocked arteries. The most common sites for diabetic ulcers are on the foot. According to Beth Israel Deaconess Medical Center (Harvard Medical School), about 25 percent of diabetics develop foot disorders, including ulcers.

  1. Diabetic Management

    • "Brunner and Suddarth's Textbook of Medical-Surgical Nursing," outlines a number of treatments for diabetic ulcers, beginning with the management of diabetes. Diabetic ulcers heal more slowly if your blood sugar varies widely, so maintaining your blood sugar within normal limits and your hemoglobin A1C, which shows your average blood sugar over a 2- to 3-month period, below 6.5 to 7 promotes healing.

    Lifestyle Changes

    • Smoking constricts the arteries and interferes with blood supply to diabetic ulcers, so you should quit smoking. Obesity also impairs circulation, so attaining a normal weight may help promote healing. Exercise is important to increase circulation, but you should avoid pressure on the foot, so you may need a modified exercise program.

    Medical Treatment

    • High blood pressure can decrease circulation to the diabetic ulcer, so treatment with vasodilators to open the vessels and increase blood flow can help to heal your ulcer. Wound infections may further erode away tissue and prevent healing, so if your wound is infected, you may require antibiotics.

    Wound Care

    • Wound care that allows the surface of the ulcer to remain moist can promote healing. Various types of dressings, including alginate and hydrocolloids, are used, depending on the amount of drainage and depth of the ulcer. According to the website RxList.com, the FDA has approved Regranex gel to treat diabetic ulcers with adequate blood supply. Regranex is applied directly to the ulcer for 12 out of 24 hours. Regranex is produced by recombinant DNA technology and contains growth factors to promote healing.

    Hyperbaric Oxygen

    • Hyperbaric oxygen therapy, in which you breathe 100-percent oxygen while enclosed in a pressurized chamber, is increasingly used to treat diabetic ulcers. It improves circulation and oxygen supply to the ulcer and promotes angiogenesis (the development of new vessels) and tissue. Topical hyperbaric oxygen therapy, in which only part of your body is encased in a portable hyperbaric device such as the Numobag, applies oxygen directly to the wound to promote healing.

    Surgery

    • The most common surgical treatment is excision of necrotic (dead) tissue from the surface of the wound, especially with large ulcers. The necrotic tissue prevents healing, and the ulcer may continue to erode and deepen underneath. Additionally, most other treatments require removal of necrotic tissue.

      If ulcers relate to impaired circulation, bypass grafts, in which a vein from another part of the body is used to bypass a clogged artery, may increase blood supply to the ulcer area. If only a small area of an artery is blocked, an angioplasty to open the artery may be successful. In severe cases where the ulcer will not heal or gangrene occurs, the surgeon may amputate the foot and/or part of the lower leg.

Diabetes - Related Articles