Authored by Debra Cornelius in Medicine
Published on 08-21-2009
Medications for diabetic ulcers should always be used only under the supervision of a doctor or wound specialist. Your doctor can monitor the changes in the wound and make adjustments to the medications used to treat your diabetic ulcer appropriately. Diabetic ulcers can lead to amputation if not cared for properly. Medications used to treat diabetic ulcers will depend on the extent of the wound, as well as any signs of infection that may be present. Early intervention and medical treatment will go a long way in keeping your feet healthy as long as possible.
Diabetic ulcers, also called Neurogenic ulcers, occur due to a decreased sensation of the feet experienced by approximately 15% of individuals diagnosed with diabetes. The lack of sensation to the feet increases the likelihood of injuries, abrasions or pressure going unnoticed. This leads to open wounds on the feet, most commonly on the soles or balls of the foot, however they can occur anywhere chafing or pressure goes unnoticed.
Medication & Treatments
Medication and treatments for diabetic ulcers include the use of moist dressings , topical treatments applied directly to the diabetic ulcer and may include antibiotics or platelet derived growth factors.
Moist dressings are usually the first course of treatment for diabetic ulcers. These moist dressings promote healing after all unhealthy tissue has been removed and the wound cleansed. Moist sodium chloride dressings or isotonic sodium chloride gel dressings such as Duoderm are perhaps the simplest to use. Moist dressings provide a clean moist environment that promotes wound healing from the inside out.
Antibiotic treatment for infected diabetic ulcers may include applications of Silvadene creams or ointments for individuals without known allergies to sulfa drugs. In the case of sulfa allergies, bacitracin-zinc or over-the-counter Neosporin ointment may be used. If the diabetic ulcer is deeply infected an irrigation of Dakin solution and 25% acetic acid may first be used.
Platelet-derived growth factors (PDGF) such as Becaplermin gel 0.01% which is produced by genetic engineering has been shown to promote speedy healing in non-infected, wounds already showing granulation or the production of new tissue.
The use of any medication or treatments for diabetic ulcers is dependent on keeping all pressure off the foot while healing occurs. In the case of multiple or extensive diabetic ulcers, this may require bed rest during early treatment. If your doctor finds it advisable, a walking cast may be applied that protects the diabetic ulcer by keeping pressure off the area while still allowing some range of mobility.
Individuals with diabetes can develop peripheral neuropathy (decreased sensation in the feet) without being aware of it, this increases the possibility of undetected injuries to the foot that can develop into diabetic ulcers that go untreated.
Regularly scheduled exams every 6 months by your doctor or a foot specialist familiar with diabetic complications can detect any problems early on.
Pay attention to routine self-care and safeguard your feet at all times.
Prevention Tips
- Never go barefoot
- Inspect your feet daily checking for any signs of redness, swelling or breaks in the skin.
- Keep toenails trimmed,
- Be sure to wear well cushioned, well fitting shoes and non-binding socks.
- If you have already been diagnosed with peripheral neuropathy it may be advisable to ask your doctor about specialty shoes.
- Do not use over-the-counter treatments for corns, callouses or warts.
Resources:
Diabetic Ulcers-Information for Adults. VisualDxHealth
Diabetic Ulcers: Treatment & Medication. Richard M. Stillman, MD, FACS. Emedicine.Medscape
