Taking a holistic approach to patient treatment.
The therapy approach diabetic foot ulcers goes far beyond wound healing. The right treatment of the underlying disease is just as important. A balanced diet and patient compliance, for example, are important factors for recovery. For some patients, the psychological stress of diabetic foot ulcers cannot be underestimated. Support from a psychologist can prove helpful.
Systemic control
Patients will need to follow an appropriate diet. Depending on the severity of the diabetes this may be supplemented either by oral antidiabetic drugs or systemic insulin injections. In all cases, regular checks are required.
Infection control
In addition to local reduction of the bacterial load, e.g. by bacteria-binding dressings, a systemic antibiotic therapy may be appropriate.
Pressure relief
Pressure relief is playing an important role when it comes to healing diabetic foot ulcers. There are several aids that can support the healing process. A total contact cast, as an example for off-weight casting, allows the wound to heal while at the same time, the patient can remain mobile. As an alternative, orthopaedic “walkers” relieve the foot from pressure during the day and can be removed for personal hygiene and during the night.
Nutrition
Patients with diabetes require a diet which is adapted to the disease. Seminars and internet websites help patients to make the necessary switch to a healthy and fibrous diet.
Regular assessment
Regular assessment of the feet helps to prevent diabetic foot ulcers. In seminars patients are trained how to examine their feet for pressure areas and injuries when body areas are desensitised due to neuropathy. A professional pedicure is also recommended on a regular basis.
Skin care
Increased blood-sugar levels narrow the blood vessels and affect nerves. In case of development of a diabetic polyneuropathy the production of sweat and sebum decreases, resulting in dry and scaly skin. Appropriate care is provided by a moisture-balancing product, preferably containing urea.
Compliance
Patients need to understand the effects that this disease has on their life; it must also be made clear what they can and must do to actively reduce complications. Training sessions, consultations and therapeutic treatments are all recommended to promote patients’ compliance.
