What is an ulcer?
A foot ulcer is an open sore on the foot. A foot ulcer can be shallow with a red crater that involves only the skin surface or, a deep crater that extends through the full thickness of the skin.
Patients with diabetes or poor circulation are more likely to develop foot ulcers. Patients with these conditions are prone to issues with infections, which can become difficult to heel if not diagnosed quickly.
An infection in an ulcer (when not treated) can develop into the following:
- An abscess (a pocket of pus)
- A spreading infection of the skin and underlying fat (cellulitis)
- A bone infection (osteomyelitis)
Foot ulcers are especially common in people who have one or more of the following health problems:
- Peripheral neuropathy. This is nerve damage in the feet and/or lower legs. Where un-controlled diabetes is the most common cause.
- Circulatory problems. Any illness that decreases circulation to the feet can cause foot ulcers. Less blood reaches the feet, which deprives cells of oxygen. This makes the skin more vulnerable to injury. And it slows the foot’s ability to heal.
- Abnormalities in the bones or muscles of the feet. Any condition that distorts the normal anatomy of the foot (where loss of sensation occurs) can lead to foot ulcers.
- Arteriosclerosis. This condition involves poor circulation to the legs.
- Raynaud’s phenomenon. This condition causes sudden episodes of decreased blood flow to the fingers and toes
In most cases, your AMA podiatrist can tell that you have a foot ulcer simply by looking at your foot.
If you have diabetes, your podiatrist will refer you to your gp for further investigation and a detailed report. Your skilled podiatrist will ask about the care that you take to keep your feet healthy and will ask about the type of shoes that you usually wear.
At AMA Podiatry we will evaluate the ulcer to determine:
- How deep the ulcer is
- Whether there is an infection
- Whether that infection has developed into cellulitis (a deep skin infection) or osteomyelitis (an infection of the bone near the ulcer)
- Whether you have any foot abnormalities, circulatory problems or neuropathy that will interfere with healing.
Our skilled podiatrist may ask you to walk as part of your examination. This is because your gait may highlight knee and ankle abnormalities that cause abnormal pressure spots on the feet. We will also look for other foot problems, such as abnormal function, fallen arches or flat feet.
To check for neuropathy, our podiatrists may:
- Test the sensation in your feet
- Check your reflexes
- Use a tuning fork to see if you can feel the vibration in your toes
- Doppler check for peripheral circulation
As part of our consultation, we will test the circulation in your legs and feet using Doppler to test your circulation.
Treatment would be in consultation with your general practitioner, and the wound clinic at your local Hospital. In most instances, healing can take weeks, or months. Depending on the type of ulcer and consistency of treatment.
Your AMA Podiatrist then may consider as part of your treatment plan, use debridement (removing diseased tissue), remove nearby callused skin, apply wound treatments, paddings and dressings and consult with family members for at home care for their loved ones. We will organise frequent visits to examine and carry out follow up treatments
Care of a foot ulcer can require multiple visits over weeks or months. The visits will last for as long as it takes for your ulcer to heal completely. If there is a possibility of infection, or complications our podiatrist will work with your doctor and family to monitor and adjust treatments where required.