Neuropathic Foot Ulcer Treatment in Lubbock TX form as a result of a loss of peripheral sensation due to problems or damage to the sensory nerves. Neuropathic foot ulcers commonly affect individuals with diabetes.
Neuropathic Foot Ulcer
Peripheral neuropathy affects the sensory nerves. The sensory nerves are responsible for detecting sensations such as temperature, pain, and other sensations in the body. Peripheral neuropathy can also affect the motor nerves. The motor nerves are responsible for the contraction of muscles.
When the motor nerves get damaged, it could lead to muscle wasting. This results in a motor imbalance of flexor and extensor muscles which could result in foot deformities. Motor imbalance can lead to increased pressure points that are prone to ulceration.
Repeated stress on a foot with reduced or loss of sensation can lead to neuropathic foot ulcer. Nerve damage reduces sensitivity to foot pain and could result in painless wounds that can lead to ulcers.
Ulceration commonly occurs in areas of high pressure of the foot, such as under the hallux (big toe), metatarsophalangeal joints, the tops and ends of the toes, the middle and sides of the foot, and the heel.
Symptoms of Neuropathic Foot Ulcers
Signs of neuropathic foot ulcers are not always obvious as you may not feel pain at the initial stage of the ulcer. The appearance of neuropathic foot ulcers will vary depending on the location and patient’s circulation.
Symptoms of Neuropathic Foot Ulcers
The signs and symptoms of neuropathic foot ulcer may include:
- Appearance of calloused blisters which are reddish to brown/black surrounding the ulcer
- Drainage from the ulcer
- Unusual swelling and irritation
- Bad odors from the ulcer
- Whitish discharge
- Numbness
- Pain
- Partial or complete gangrene (tissue death)
Risk Factors for Neuropathic Foot Ulcers
Risk Factors for Neuropathic Foot Ulcers
People with diabetes are generally at risk for foot ulcers. There are certain factors that can increase the risk of neuropathic foot ulcers. These include:
- Poorly fitted or poor quality shoes
- Poor foot hygiene
- Improper trimming of toenails
- Alcohol consumption
- Heart disease
- Kidney disease
- Obesity
- Smoking
- Renal failure
- Trauma
- Surgery
- Poor glycemic control
- Hypertension
- Foot deformities such as a bunion, flatfoot, hammertoes, etc
Treatment of Neuropathic Foot Ulcer
If left untreated, neuropathic foot ulcers can lead to osteomyelitis (infection of the bone or bone marrow). The combination of pressure-related ischemia, neuropathy, and a delayed healing response can allow the infection to worsen if not timely treated.
Treatment of Neuropathic Foot Ulcer
Neuropathic foot ulcer is typically painless due to loss of sensation unless there is an infection. Severe cases of neuropathic foot ulcers can lead to amputation.
Treatment of neuropathic foot ulcer includes:
Off-loading
This is taking pressure off the affected foot. Reducing pressure on the affected foot is one of the most essential components to effectively healing neuropathic ulcers. Relieving pressure from the foot should be balanced with encouraging proper circulation. Contact casts or removable cast boots can be used to decrease pressure on the affected foot. Therapeutic shoes can also be used to decrease pressure on the ulcer and also to prevent the recurrence of the ulcer.
Debridement
Debriding the ulcer by removing the top dead necrotic layers is the next treatment step. Without Debridement, medications and cleaning of the wound will not be effective. After Debridement, your doctor can get to the healthy, bleeding tissue.
Debridement allows for better assessment of the ulcer and any underlying infections that may be present. It also provides a better healing environment.
Disinfecting the skin around the ulcer
Disinfecting the skin around the ulcer helps to prevent infection and also aid healing. Your doctor may also apply ointment on the ulcer to aid healing. The ulcer should be kept moist for quicker recovery.
Dressing
The ulcer shouldn’t be left bare. It should be properly dressed to prevent contamination from dirt and bacteria. Use dressing with calcium alginates to prevent bacterial growth and keep the ulcer dry with frequent dressing changes. Remove old dressing when it gets wet from the secreted fluids from the ulcer and replace it with a new dressing. Dressing may be changed once every day.
Medications
If the ulcer is infected, your doctor may prescribe antibiotics, anti-platelets, or anti-clotting medications to treat the infection. Your doctor may also recommend taking pain medications such as acetaminophen if you feel increased level of pain. Avoid blood-thinners.
Surgery
If the ulcer does not resolve after using other conservative treatments, surgery may be recommended. Surgery may be done to apply cellular or acellular tissue supplements or to correct deformities in the foot.
Amputation
This is for very severe cases with no solution. If the condition of the foot is very severe and can’t be treated, your doctor may suggest amputating the affected foot to prevent the ulcer or infection from spreading to other parts of your body. Amputation is the last resort when the ulcer is not responding to any treatment, getting worse, or untreatable.
