Diabetic Foot Wound Assessment
It should not be assumed that a foot wound is a diabetic foot ulcer without ruling out other causes that can include venous ulcers (caused by improper functioning of venous valves, usually of the legs), ischemic ulcers (caused by arterial insufficiency), vasculitic ulcers (caused by inflammatory destruction of blood vessels), and malignancies.
Diabetic Foot Wound Assessments in Dallas, TX
A full examination and documentation of findings must be completed prior to a diagnosis of a foot wound. This ensures that the proper treatment plan is established. Foot ulcer evaluation should include assessment of neurological status, vascular status, and evaluation of the wound itself. This includes vital information such as wound size, shape, location, depth, base, and border, as well as signs of infection and deterioration.
Neurological status can be checked by using 10-gram monofilaments. This is an effective method of testing for the presence or absence of “protective sensation.” Patients are deemed to have lost their protective sensation if they cannot feel a 10-gram monofilament pressed against their skin. As a result of this lack of sensation, their foot is now “at risk.” This means the patient is more likely to damage their foot without feeling it. However, it is also necessary to test for vibratory sensation since approximately 10% of high risk patients can feel a monofilament, but have lost their vibratory perception. This can be done using a 128-Hz Tuning Fork. Both of these tests can be performed fairly quickly in any office setting. There are more in-depth analyses that can be performed in a neurological laboratory. These include using a vibrometer (a device designed to more accurately measure vibratory sense), assessing temperature sense, performing nerve conduction studies, and checking position sense and balance.
Vascular assessment is also an essential component in the evaluation of diabetic ulcers. This includes checking pedal pulses, the dorsalis pedis on the dorsum of the foot, and the posterior tibial pulse behind the medial malleolus. Patients with a non-palpable pedal pulse should seek further testing at a noninvasive vascular laboratory. The capillary filling time must also be assessed by pressing on a toe until the skin blanches, then timing the skin while it restores its color. A prolonged capillary filling time is considered anything greater than 5 seconds.
What Type of Doctor Treats Diabetic Foot Ulcers?
Some of the key specialists who treat diabetic foot ulcers include:
- Podiatrists – Provide comprehensive foot care and wound treatment. They can surgically debride wounds.
- Endocrinologists – Diabetes specialists who can optimize blood sugar control.
- Vascular surgeons – Treat circulatory issues contributing to foot ulcers.
- Infectious disease specialists – Diagnose and treat wound infections.
- Plastic/reconstructive surgeons – Provide flap surgery or grafts for severe ulcers.
- Wound care nurses – Expert ulcer care and dressings.
What Is The Fastest Way To Heal A Diabetic Foot Ulcer?
Some effective ways to speed diabetic foot ulcer healing include:
- Offloading pressure on the wound using special boots or devices. This is key to allow healing.
- Regular debridement of dead tissue by a podiatrist. This stimulates healing.
- Maintaining optimal blood sugar levels through medication, diet, and exercise.
- Using advanced dressings that provide a moist wound environment.
- Treating any wound infections quickly with antiseptics or antibiotics.
- Improving circulation through revascularization procedures if needed.
- Amputation of any non-viable tissue or osteomyelitis.
- Following the treatment plan from your specialized wound care team.
With comprehensive treatment, most foot ulcers can heal within 12 weeks. Seeking immediate care is important to prevent worsening.
Contact Our Office
Wound Integrity is proud to offer patients many advanced solutions to their wound healing problems. We provide a clean, moist environment that is conducive to healing for most wounds and helps lead toward a quick and efficient recovery, while keeping cosmetic concerns in mind as well. Contact us today to book your appointment.