So Your Parent Has A Foot Ulcer. How Can You Help?
When we age and develop age-related health conditions or problems, it’s common for our circulation to be affected. This means that we may become more vulnerable to leg and foot ulcers – and even more vulnerable than ourselves, are our parents.
As podiatrists that have seen our older family members develop ulcers associated with diabetes, peripheral vascular disease and circulation issues (among other problems), we thought we’d share why this occurs, what you can do to help, and how we help our own families efficiently heal their ulcers.
What is an ulcer – and how is it caused?
Foot ulcers are open sores on the surface layers of the skin. When the healthy tissue breaks down, ulcers develop and may go as deep as to expose bone – or stay superficial.
Ulcers have many causes, both diabetic and non-diabetic, and it’s usually a number of things that contribute to an ulcer developing. Often, it’s related to a medical problem or condition. Areas of high pressure on the skin can also be a cause. Ulcers can be divided into four categories:
- Neuropathic
- Arterial
- Venous
- Pressure-related
Neuropathic ulcers develop when the sensation from the skin of the feet or legs is altered or lost entirely. This often happens with diabetes, but other conditions can cause neuropathy too. Neuropathic ulcers can progress quickly because you can’t feel them, so don’t notice them or know that you need to start caring for the wound so it can heal.
Arterial ulcers result from poor circulation and blood flow to the feet and legs. Insufficient blood to the tissues can cause tissue death, and hence the development of these often painful ulcers. They often occur on the feet and lower third of the legs. They carry a higher risk of infection as good circulation is necessary to efficiently clear infections. This means they can be present for a prolonged time.
Venous ulcers occur from problems with the veins where they struggle or fail to complete their function – to move fluid away from the legs. This leaves the fluid to pool in the legs, resulting in foot and leg swelling, and greatly increases the venous system pressure which then leads to the ulcer. These are often seen around the lower legs and ankles.
Pressure-related ulcers are often referred to as pressure sores, and occur from prolonged pressure to an area of skin. This is often observed in those confined to their beds, where ulcers develop on the buttocks or the back of the heels. Often there are other associated conditions that lead to the development of these ulcers.
How do I know if it’s an ulcer?
Foot ulcers are more or less circular in shape, and may have distorted edges. They start as a reddened area that blisters, peels or cracks to create an open wound. They often weep and may have some bloody discharge. The layers of skin become thin and the ulcer may expose bone, muscle or tendon.
The edges may also become brown/black, or stay pink/red. If an infection occurs, the ulcer may have patches of yellow/green and may produce exudate and an unpleasant odour.
Where compromised blood flow has contributed to the development of an ulcer, there is a risk of infection because circulation may be insufficient to effectively fight any developing infection.
How are ulcers treated – generally?
Because ulcers put patients at risk of serious complications, it is important that ulcers are treated professionally and effectively. Your treatment will depend on the type and cause of your ulcer. Because of the often systemic nature of ulcers, treating the cause often involves looking at your overall circulatory issues, venous problems, and the management of diabetes if present.
How we treat ulcers at The Podiatrist
When it comes to treating ulcers, we start with the essentials and then move to our *secret weapon*.
We start by:
- Debriding the ulcer if needed to remove any dead tissue that is limiting its healing process
- Helping you manage infection where present
- Off-loading pressure away from the ulcer through pads, orthotics, footwear or total contact casting
- Liaising with other health professionals required for the best management of your ulcers
- … And then comes our secret weapon – Bodyflow.
The Bodyflow machine significantly enhances your circulation, thereby promoting the blood flow to repair and heal the ulcer. This is an ulcer that we treated using Bodyflow in a 74-year-old male that had peripheral vascular disease. We achieved complete healing within 5 weeks.
