Patient/caregiver were instructed on the findings of diabetic foot ulcers to watch for and report to the physician as follows:
- 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. The neuropathy could also affect the sweat glands of the feet, resulting in reduced sweat production. Individuals with active or history of diabetic foot ulcers should closely inspect their feet every day, especially the undersurface of the feet, and report to the physician regarding any & every event of risk for skin integrity, such as, development of new – calluses, dry & cracked skin, open wound sites, accidental injury to the feet, and so on. Individuals needing caregiver assistance to perform this task should seek appropriate assistance from available and willing caregivers.
- As individuals with poor sensation in the feet could be walking and moving around without realizing the wounds on their feet, these wound sites are increasingly exposed to risk for further friction & pressure and risk for infections. Poorly managed diabetics could also present with compromised blood circulation in the distal lower extremities, which can result in diminished blood supply to the ulcer site, contributing to increased risk for delayed healing at the ulcer site, development of secondary bacterial infections, and dead tissue formation. Bacterial infections at the wound site can result in symptoms of infection, such as, swelling around the wound site, local elevation of temperature, and foul smelling drainage. Development of dead tissue at the ulcer site can lead to necrosis & gangrene, giving the wound site a black discoloration. Individuals with active or history of diabetic foot ulcers should closely inspect their feet every day, especially the undersurface of the feet, and report to the physician regarding any signs and symptoms of infection, new or increase in the drainage, change in the color of drainage, if any, to yellow, increase in the foul smell of the drainage, black discoloration at the wound site, and so on. Individuals needing caregiver assistance to perform this task should seek appropriate assistance from available and willing caregivers.
