Patient/caregiver were instructed on the complications that could arise from poorly managed diabetic foot ulcers as follows:
- Diabetic foot ulcer usually is an ulcer with full-thickness skin loss and a circular punched out appearance. The ulcer site is surrounded by hard callus, which is thickened and hardened portion of the skin. Due to the neuropathy in poorly managed diabetics, individuals often have poor sensation at the ulcer site, which contributes to the painless nature of the wound. As these wounds are mostly painless, it is often delayed by the time these wounds are realized. Patients, secondary to poorly controlled neuropathy, can as well present with burning, altered/tingling sensation, or numbness in the feet.
- Secondary infections at the wound site can result in swelling around the wound site, local elevation of temperature, and foul smelling drainage. Patients can as well present with fever and chills, secondary to infection, but can often be absent.
- Poorly controlled neuropathy in the foot during later stages can also result in compromised nerve supply to the numerous small intrinsic muscles in the foot, which control the action of toes and maintain the shape & arches of the foot. Poor nerve supply to the intrinsic muscles of the foot leads to progressive atrophy of these muscles, resulting in stiffness & contractures of the toes and compromised arches of the foot. Altered shape of the foot in individuals with neuropathy can further lead to increased exposure of the foot to mechanical factors, such as, friction, pressure, and shearing stress. This can increase the risk for development of new pressure points and calluses on the foot with potential to progress in future towards development of new diabetic foot ulcers.
