Total Contact Casts A Game
Story by Kirsten Goruk
Its taken a decade for Ian Irons to finally be cured of an ulcer on his foot but, thanks to a new cast treatment, he and his feet are a lot happier these days.
Nothing seemed to help it, says Irons, 72. Then they came up with this cast. I had it for close to three months and my ulcer is gone. Three months compared to 10 years is a huge difference.
Irons is undergoing a new therapy known as total contact cast treatment at the outpatient clinic at the Queen Elizabeth II Hospital in Grande Prairie. Ten years ago, he had a callus on his foot removed, but the wound never healed, so he was recommended for the innovative therapy.
I could feel the difference right away when they put the cast on, he says.
Total contact cast therapy began as a clinical trial for diabetic foot ulcers a year ago, but was so successful it is now a treatment option.
It helps heal foot ulcers by distributing weight equally along the entire foot area. The entire cast, which provides padding and support, is in full contact with the foot and part of the leg, thus its name. It is covered with a walking boot. It relieves pressure on prominent areas of the foot, including ulcers, allowing them to heal.
Patients wear the cast, then once a week it is removed and the wound inspected. A new cast is reapplied and the boot is put back on. Depending on the severity of the ulcer, weekly casting may continue for up to several months.
Use Of The Medication
As mentioned earlier it would be a wise decision for the patient to consult with a medic. The doctor should be able to prescribe medication that would help fight against the bacteria causing the infection.
This would also be a safer option as the doctor will be able to advise you on the appropriate medication to take especially if you have any underlying conditions.
A Medical Practitioner May Advise You To Undergo Surgery To Remove The Ulcers However It Would Be Best To Seek This As A Last Resort If Other Treatments Do Not Work
If you decide to have the surgery done it would be best to look for an experienced surgeon who would ensure that your foot ends up in good shape.
There are certain preventive measures that the patient could take to ensure that they do not end up with foot ulcers.
These measures include:
Maintain a high level of hygiene- hygiene has always been emphasized as a factor to maintain good health. It still applies to foot ulcers. It is advisable to maintain clean feet by washing them daily.
Wear shoes of the correct size- sometimes these foot ulcers may occur due to the feet being compressed and lack of proper blood circulation to the feet. You should, therefore, always have the size of your feet in mind as you purchase shoes.
Regularly visiting your doctor- everyone should make sure that they incorporate a visit to the podiatrist in their monthly physical examination. This would help in diagnosing any issue early before it gets worse.
Ensure your feet are desiccated- wet feet are more prone to get infections hence it is always best to keep your feet dry.
With the above measures, you should be able to steer clear of foot ulcers.
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Treatment Options For Foot Ulcers
A DFW wound care doctor can examine your feet, check for signs of infection, and recommend treatment options for your diabetic foot ulcer based on your specific condition and needs. For foot ulcers that are severely infected or spreading to other areas, hospitalization may be needed.
According to our DFW wound care doctor, some of the most common treatments for a foot ulcer are:
- Off-loading.Off-loading is recommended to take pressure off the ulcer. This can be done by using padding over the ulcer, crutches while walking, a brace or cast on the foot, or a compression wrap.
- Medication. If there are signs of an infection, an antibiotic ointment can be put on the ulcer then covered with a dressing or bandage. An oral antibiotic may also be prescribed to help with infection.
- Cleaning. The ulcer should be kept clean and dry. This can be done by washing the ulcer daily with a mild soap and warm water and changing any dressings or bandages used to cover the ulcer.
- Debridement. Removing any dead skin or tissue by debridement is often done to speed up the healing process. Debridement is done by a podiatrist using a sharp tool to remove the skin and tissue.
- Surgery. If more conservative foot ulcer treatments have not been successful, surgery may be recommended. Surgery can be done to correct a foot deformity such as a hammertoe or bunion that is causing the foot ulcer. Also, shaving or removing bones is an alternative option.
Are Foot Ulcers Curable
Typically, shallow foot ulcers with adequate blood circulation heal within 12 weeks. A third of all cured foot ulcers are at risk of recurrence owing to a lack of prophylactic and remedial actions. Deep ulcers with a high infection rate and poor circulation may need surgery and a prolonged healing period.
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Why Is Foot Ulcers Healing Slow
When you have diabetes, several factors can affect your bodys ability to heal ulcers. A diabetic foot ulcer has various causes, often including external ischemia, neuropathy, or both. A few of them include:
- High blood sugar levels
- Immune system deficiency
If you get an ulcer or notice any change in your skin that youre unsure about, consult a doctor, could be a primary doctor or a diabetes specialist. A debridement procedure will be given to the infected area, removing unhealthy tissue from the wound to spur healing. The doctor will also work with you to keep your sore or ulcer from getting infected and becoming more significant.
If the foot ulcer doesnt heal within a month or the infection spreads to the bone, in this case, patients may need other treatments. These can include surgery and hyperbolic oxygen therapy to help the body heal.
Can Diabetic Leg Ulcers Be Cured
Are diabetic ulcers capable of necessitating amputation? When foot ulcers do occur, it is critical to seek treatment promptly. Amputations begin with foot ulcers in more than 80% of cases. A nonhealing ulcer that has caused significant tissue and bone damage may need surgical removal of a toe, foot, or portion of a leg. Certain individuals with diabetes are at a higher risk than others.
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What is the appearance of a diabetic leg ulcer? Discoloration: One of the most prevalent indications of diabetic foot ulcers is the appearance of black or brown tissue called eschar surrounding the lesion as a result of decreased blood supply to the feet. Wounds that have developed to the level of being coated with eschar may cause serious complications.
Is a diabetic ulcer considered to be a full-thickness wound? Diabetic foot ulceration is full-thickness penetration of the foots dermis in a diabetic individual. The Wagner method is often used to classify the severity of ulcers. Grade 1 ulcers are superficial ulcers that include the whole thickness of the skin but do not involve any underlying tissues.
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How Can A Foot Ulcer Be Prevented
The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis. He or she can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.
You are at high risk if you:
- Have neuropathy
- Have a foot deformity
- Wear inappropriate shoes
- Have uncontrolled blood sugar
Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose are important in the prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. Your podiatric physician can provide guidance in selecting the proper shoes.
Learning how to check your feet is crucial in noticing a potential problem as early as possible. Inspect your feet every dayespecially between the toes and the solefor cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your podiatrist or a medical professional as soon as possible, no matter how simple it may seem to you.
The key to successful wound healing is regular podiatric medical care to ensure the following gold standard of care:
- Lowering blood sugar
How Are Foot And Toe Ulcers Treated
The goal of treating a foot or toe ulcer is to relieve pain and heal your wound. Your treatment plan will be individualized based on what medical condition is causing your ulcers. If you cant correct the cause of your ulcer, its likely to come back after treatment.
There are both surgical and nonsurgical treatments for foot and toe ulcers. For simple, early stage foot and toe ulcers, nonsurgical treatments may work. Ulcers that are more advanced, especially ones that are infected, may require surgery.
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Are Foot Ulcers Treatable
Debridement is the process of removing diseased or dead skin and tissue from a foot ulcer. It enables your doctor to evaluate the degree of soft tissue injury and promote recovery. A doctor uses a knife or other sharp instrument to remove tissue from inside and around the incision during this treatment.
What Tests Will Be Done To Diagnose The Cause Of A Vascular Ulcer
Your healthcare provider or a specialist will do the following:
- Blood pressure. Your provider will take the blood pressure on your arm. Theyll also take a blood pressure reading in your legs to see if theres a difference between the two. This is called the ankle-brachial index test.
- Listen to your heart and check your pulse. Listening to your heart and breathing sounds, your provider may find evidence of an underlying heart problem that could be contributing to vascular ulcers. Theyll also feel for a pulse in your lower legs and feet, which are called peripheral pulses. Depending on the strength of the peripheral pulse or if it cant be felt at all your provider can narrow the focus of their diagnosis.
- Blood testing. Blood tests can help a provider make a diagnosis or help them determine how to treat the ulcer going forward. One test, in particular, is the A1C hemoglobin test, which can determine if you have diabetes, and its severity if diabetes is found.
- Imaging. Your provider may order imaging tests to examine not just the wound itself but also the blood flow around it. They may also order imaging on major arteries and veins elsewhere in your body, as these can also show signs of problems related to a vascular ulcer. These tests can include X-rays, MRIs, CT scans and ultrasounds.
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When You Need More Treatment
If your wound doesnât heal in about a month or becomes an infection that spreads to the bone, you may need other treatments. These can include surgery and hyperbolic oxygen therapy, which involves breathing pure oxygen in a special room in order to help your body heal.
If your ulcer develops gangrene and your tissue dies, your doctor may have to amputate that area of your body.
What If A Leg Ulcer Does Not Heal Properly
If you have a wound or sore that is not healing properly, schedule an appointment with your primary care physician as it may develop into or be the start of a leg ulcer. You may be scheduled to see a nurse rather than a doctor, since nurses are often responsible for the care of patients with leg issues.
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What Does A Foot Ulcer Caused By Diabetes Look Like
If the stage of the ulcer has progressed, it should be evident. A foot ulcer resembles a red, round crater in the skin that is surrounded by thicker, calloused skin. Ulcers of severe severity might be so deep as to reveal tendons or bones. However, some symptoms may be difficult to diagnose or may indicate another issue.
Guidelines For Prevention And Care
Follow the below guidelines for prevention and care from foot ulcers:
Dont walk barefoot if diabetic and take proper foot care to avoid foot ulcers.
Avoid taking any risks when it comes to diabetic foot ulcers and other diabetes-related wounds. If you see any signs of foot infection consult your doctor immediately. The faster you receive medical advice the less are the chance of an infection.
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What Is The Best Ointment For Diabetic Wounds
Topically applied antibiotics such as Neomycin, Gentamycin, and Mupirocin provide effective antibacterial coverage. Silver-containing dressings are available in various formulations and provide excellent antibacterial coverage. Diabetic foot wounds have been successfully treated with silver dressings and polyherbal formulations .
Side Effects Of Leg Ulcers
- A green and foul-smelling discharge from the ulcers
- The skin around the ulcers begins to swell
- The sores become bigger
- Inflamed skin around the ulcers
The fear of developing these complications is enough for you to try and battle these nasty-looking sores at the earliest. Taking the necessary precautions and using the remedies mentioned above on a daily basis, without fail, should help heal leg ulcers pretty fast. Nevertheless, you must see your doctor immediately if the ulcers on your leg seem non-healing or worsen in their appearance. Try the remedies listed in the article and let us know if they worked for you.
Prolonged Pressure On The Feet
As mentioned in the previous example, when shoes fit poorly, ulcers can occur. In people without nerve damage, this is usually due to severe atherosclerosis, or a deformity such as a fracture. Elderly patients often have difficulty or find it uncomfortable to examine their feet, ignoring moderate pain from pressure on the feet, which may result in the development of an ulcer.v
Is It Possible For An 80
Overall mortality after major amputation was 44%, 66%, and 85% after 1, 3, and 5 years, respectively. In patients aged 80 years or older, 6-month and 1-year death rates were 59 percent and 63 percent, respectively, after a secondary amputation of 3 months, compared to 34 percent and 44 percent following a secondary amputation of > 3 months.
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Causes And How Foot Ulcer Happens
The cause of diabetic foot ulcers is mainly due to the following:
- Poor blood circulation
- Nervous damage
- Feet irritated or wounded
Due to vascular disease, the blood flow is not proper in the body. This results in poor blood circulation and results in leg swelling, blood clots, etc. These can cause ulcers in the inner part of the leg just below the knees.
A high glucose level in the blood slows down the bodys healing process due to which any small infection can turn out to be serious. People with type 2 diabetes are more vulnerable to foot ulcer infections.
Excess fluid in lymph causes swelling in nearby soft tissues of the leg and arms. This condition is called Lymphedema and can lead to fluid-filled ulcers. It can be painful and can become serious if left untreated.
Nerve damage can be due to diabetes or an injury and causes loss of sensation around the affected area. It has a long-term impact and can result in loss of sensation. Nerve damage reduces the sensitivity to foot pain due to which one can have painless foot ulcers.
Diabetes, poor circulation, nerve damage, swelling in lymph, and improper diabetes management are causes of foot ulcers.
How Is A Vascular Ulcer Diagnosed
A healthcare provider can quickly diagnose a vascular ulcer by examining it. They will look closely at the ulcer and may feel the area around it, checking for specific symptoms.
However, your provider will also want to diagnose whatever caused the ulcer. Parts of their examination of the wound will help them do this, but they will also order certain tests to help them fully understand the cause, mainly because vascular ulcers can have multiple causes and many of those causes can be connected.
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How To Treat Ulcers
If you do get an ulcer or notice a change in your skin that youâre not sure about, tell your doctor right away. Youâll likely get a procedure called debridement, which removes unhealthy tissue from the wound to spur healing.
Your doctor will also work with you to try to keep your sore or ulcer from getting infected and becoming bigger. Some of the steps they may recommend include:
Clean your ulcer daily. Use soap and water, unless your doctor recommends another cleanser. Donât use hydrogen peroxide or soak your wound in a bath or whirlpool, because this could reduce healing and may boost your odds of infection.
Keep your ulcer bandaged or covered with a wound dressing. While you may have heard that itâs important to âair outâ wounds, experts now know that not covering a wound actually increases the odds of infection and slows healing.
Keep pressure off your ulcer, especially if itâs on your foot. This may mean you need to use crutches, special footwear, a brace, or other devices. Reducing pressure and irritation helps ulcers heal faster.
Use the topical medications your doctor recommends. These may be saline, growth factors, and/or skin substitutes.
Keep your blood sugar under control. In addition to reducing your risk of ulcers, tight blood sugar control helps your body heal existing ulcers.