What is a foot ulcer?

An area of skin has broken down and the tissue underneath it is now exposed.

Why do I have a foot ulcer?

These can present as a result of many reasons, such as trauma (for example from footwear). In some people the skin does not heal very well due to certain medical conditions, therefore more likely to develop an ulcer or infection after only a minor injury.

In conditions such as rheumatoid arthritis or diabetes, the shape, the circulation and the sensation in your feet may be affected.

A foot ulcer can become infected which increases the risk of amputation and, if not treated quickly and effectively, the possibility of early death. If the circulation to your feet is poor, this further increases these risks.

Danger signs

During your treatment for this ulcer, if you notice any of these danger signs, you must contact a member of the foot protection team: OCDEM, local podiatry clinic or GP for advice as soon as possible (within 24hours).

• Is there any pain or throbbing?
• Does your foot feel hotter than usual?
• Are there any new areas of redness, inflammation or swelling?
• Is there any discharge?
• Is there a new smell from your foot?
• Do you have any flu-like symptoms?

If a member of the foot protection team is not available, go to your local accident and emergency department.

How can podiatrist help?

Foot ulcers are someitmes hidden beneath hard skin and can gather deadskin around them. The podiatrist will need to remove this to help your ulcer to heal. This can cause the ulcer to bleed a little but this is completely normaly.

• Do not try to treat the ulcer yourself.

What should I do?

• Do not interfere with your dressing unless agreed with the podiatrist.
• Continue to check your feet every day. If you cannot do this yourself, ask your partner or carer to help you.
• Keep your dressings dry. Consider a waterproof dressing protector.
• Moisturise the surrounding area of your feet.
• Rest as much as possible to help it heal.
• If you smoke, you are strongly advised to stop. Smoking affects your circulation and leads to higher risks of amputation of the foot or leg.
• Control your cholesterol and blood pressure.
• Attend your medical appointments.
• Wear footwear recommended by your podiatrist.
• You may be asked to wear a cast, have special padding on your foot or wear a temporary wound shoe to relieve pressure until the ulcer has healed.

How to eat well for wound healing?

Your body needs energy (calories), proteins, fluids, vitamins, and minerals every day, especially if you have a wound that is healing. Eating well helps your body heal faster and fight infection. Here is some advice to help you get the nutrition you need to help your wound to heal.

• Eat a balance of healthy foods.
• Eat wholemeal cereals and breads, potatoes, pasta, and rice, they are important sources of energy.
• Eat meat, poultry, fish, eggs, beans, nuts, milk, yoghurt, and cheese, they are important sources of protein which is very important for wound healing.
• Plan fluid and drinks into your daily routine. Don’t wait until you are thirsty.
• Fruit and vegetables contain lots of vitamins and minerals. These help protect us against infection and help wounds to heal.
• Vitamins A and C, and minerals iron and zinc will help Food with good souces of these include meat and chicken, seafood and shellfish, beans, nuts, whole grains, broccoli, oranges, peppers, tomatoes etc.

Antibiotic treatment

You may have been given antibiotics if there are any signs of infection in the wound or nearby tissue.

Please report any problems you may have with antibiotics (e.g. rashes, nausea or diarrhoea) to the person who prescribed them for you. If this person is not available, contact your GP immediately for advice.

DO NOT STOP taking them until you have finished the course or the person who prescribed them informs you to do so.

If the infection is getting worse (you have increased or spreading redness or pain or develop flu-like symptoms), you may need to go to the hospital immediately to help protect your limb and even save your life.

Operations

Sometimes if an infection becomes severe, you may need an operation to surgically clean the wound or amputate part of the foot to save healthy tissue.

If your circulation is reduced, you may be referred for an operation to increase the blood supply to the ulcerated area.