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Treatment of diabetic foot ulcers begins with a physician determining the cause. The physician then closely examines the ulcer, noting its location on the foot, size and possible presence of infection. Treatment of diabetic foot ulcers depends wholly on what a physician determines from his or her examination. Possibilities range from close monitoring of the ulcer and a prescription of antibiotics to surgery or amputation of the foot. No matter the form of treatment a patient receives, it becomes the patient's responsibility upon returning home to monitor the ulcer, rest and immediately consult a physician if further tissue damage should occur.
The first step in the treatment of diabetic foot ulcers is determining why the ulcer developed. This step is important, as a patient's remarks can indicate an underlying problem. Though individuals with diabetes are more prone than the general population to develop foot ulcers, the appearance of an ulcer without a physical cause such as increased walking or long periods of standing suggests to a physician that the patient is mismanaging his or her diabetes. These suspicions are easily confirmed through blood glucose level tests. High blood glucose levels indicate that an ulcer developed due to a combination of arterial hardening and neuropathy within the foot.
Whether the cause was physical injury or diabetes mismanagement, treatment of diabetic foot ulcers depends on the results of a physical examination. The width and depth of the ulcer are especially important, as a deep ulcer can expose fatty tissue and muscle. Patients with large ulcers should expect more invasive treatment and longer recovery times. During an examination, physicians also search for signs of an infection. He or she might take a swab of the ulcer to test for the presence of viral, fungal or bacterial infection.
If tests show the presence of an infection, a physician prescribes medication to the patient as he or she begins to treat the ulcer. Smaller ulcers require only a cleaning and bandaging. A physician may pack gauze into the ulcer cavity; he or she will remove it during a follow-up visit. Slightly larger ulcers may require minor surgery to removed diseased or dead tissue. A patient should expect brief hospitalization so a physician can monitor the immediate healing process.
Treatment of diabetic foot ulcers becomes complicated when a patient presents with multiple ulcers that are large and deep. These ulcers require more extensive surgery. The patient's diabetes also extends the recovery period, increasing the chances of post-operative complications such as infection. Amputation of toes and the foot itself becomes necessary when ulcers cause extensive neuropathy and arterial damage. In these cases amputation is advantageous, as the patient can more quickly resume a normal life.
Though many forms of treatment exist, responsibility for post-operative care is mainly the patient's. Upon returning home, the patient becomes responsible for changing bandages and, if necessary, continuing to take medication to fight the ulcer's infection. If the ulcer formed due to diabetes mismanagement, lifestyle changes are required to prevent future ulcers and other complications from diabetes. Even if a patient follows the instructions of his or her physician, complications are still common. A patient must seek medical attention if the same or a new ulcer reappears.