What is a Diabetic
Foot Ulcer?
A diabetic foot ulcer is an open sore or wound
that most commonly occurs on the bottom of the foot in approximately
15% of patients with diabetes. Of those who develop a foot ulcer,
approximately 6% will be hospitalised due to infection or other
ulcer-related complication.
Diabetes is
the leading cause of non-traumatic lower extremity amputations
in the developed world, and approximately 14 to 24% of patients
with diabetes who develop a foot ulcer have an amputation. Research,
however, has shown that the development of a foot ulcer may be
preventable.
In 1995, it was estimated that there were 135 million individuals
worldwide with this disease, a figure that is likely to have risen
to 154 million by 2000. By 2025, it is projected there will be
300 million individuals with diabetes across the world. The vast
majority of new cases will be type 2 (non–insulin-dependent)
diabetes, with a 42% increase of cases in developed countries and
a 170% increase in developing countries.
Who Can Get a Diabetic Foot Ulcer?
Anyone
who has diabetes can develop a foot ulcer, older men are more likely
to develop ulcers. People who use insulin are at a higher risk
of developing a foot ulcer, as are patients with diabetes-related
kidney, eye, and heart disease. Being overweight and using alcohol
and tobacco also play a role in the development of foot ulcers.
How do Diabetic Foot Ulcers Form?
Ulcers form
due to a combination of factors, such as lack of feeling in the
foot, poor circulation, foot deformities, irritation (such as friction
or pressure), and trauma, as well as duration of diabetes. Patients
who have diabetes for many years can develop neuropathy, a reduced
or complete lack of feeling in the feet due to nerve damage caused
by elevated blood glucose levels over time. The nerve damage often
can occur without pain and one may not even be aware of the problem.
Your
healthcare professional can test feet for neuropathy with a simple
and painless tool called a monofilament.
Nylon
Monofilament Test. There is a risk of ulcer formation if the patient
is unable to feel the monofilament when it is pressed against the
foot with just enough pressure to bend the filament. The patient
is asked to say "yes"
each time he or she feels the filament. Failure to feel the filament
at four of 10 sites is 97% sensitive and 83% specific for identifying
loss of protective sensation.
Vascular disease can complicate a foot ulcer,
reducing the body’s ability to heal and increasing the risk
for an infection. Elevations in blood glucose can reduce the body’s
ability to fight off a potential infection and also retard healing.
NOTE: Microcyn
does not have U.S. FDA clearance for claims other than to moisten,
lubricate, cleanse and debride wounds. |