Diabetic Foot Ulcers and Infections

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By Prof Dane Wukich MD, Charles Gregory Distinguished Chair, UT SouthWestern, Dallas, Texas, USA

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#diabeticfoot #diabeticfootexamination #diabeticfootcare #diabeticfootcaserpresentation #diabeticfootpain #diabeticfootulcercare #diabeticfootwear #diabeticfootulcerlecture #diabeticfootpathophysiology
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Free Resource: http://www.FootUlcerBook.com
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When you discover a diabetic foot ulcer, it’s a scary situation. You suddenly notice a hole in the bottom of your foot. My name is Dr. Andrew Schneider and I’m a podiatrist in Houston, TX. A diabetic foot ulcer is important to address immediately. How you first treat a diabetic old foot ulcer may dictate the speed in which it is going to heal. In today’s video I’m going to discuss the first steps you should take when a diabetic foot ulcer is discovered.

I recommend that all of my diabetic patients begin a nightly routine of inspecting their feet. This is an essential way to make sure their feet stay
healthy. What are you looking for during these inspections? You’re looking for anything that wasn’t there yesterday. For instance, be aware of any new callus, blister, erosion, sore area of bleeding or pus, and especially the start of a diabetic foot ulcer.

A diabetic foot ulcer, for lack of a better description, is a hole in the bottom of your foot. It can become infected. The infection can travel to the bone. This puts your foot at risk for amputation. My job is to prevent that from happening. That’s why the first thing you do when you discover a diabetic foot ulcer is to contact your podiatrist.

In my practice, the discovery of a diabetic foot ulcer is a medical emergency. You call and say, “I’m diabetic. And I think I have a problem.” and no matter what our day looks like we get you in. Once at the office, we’ll do some assessments on the foot ulcer. We’ll likely take an x-ray to make sure the bone isn’t involved and to make sure there’s no damaging gasses in the tissue. We may also do a circulation test to make sure you have enough blood flow to heal the ulcer. I’ll remove the unhealthy tissue of the foot ulcer to be able to see it’s true borders in depth. This is a process called debridement.

At this point. I’ll have a good idea if the wound is infected or not. This is essential to be able to offer the proper treatment. Even if the wound is not infected, I may still prescribe a course of antibiotics to ensure you’re clear of any infection. I may also swab the wound to send material to the lab, to check for infection as well.

Now it’s time to decide how to start the wound on the path to healing. A common mistake I see is to either not dress the wound or to treat it like a cut. Sometimes you may be told just to put a topical antibiotic on it. Whether prescribed or over the counter, this is the wrong approach. We want to apply a wound dressing that will keep an ideal environment for the ulcer to heal. We also want to use dressing that will promote the tissue to
heal. a topical antibiotic, or a cream such as Silvadene, do not meet these
criteria. The good news is that there are a tremendous number of wound care products on the market designed to heal your foot ulcer. Some of these wound dressings are topical gels or ointments that are easily applied to the wound at home. These are usually prescribed through your regular pharmacy.

There are other types of dressings that promote the healing of a diabetic foot ulcer. I change to these dressings. If I don’t see the wound progressing to become closed, I don’t like to see a wound stagnating. These dressings fall into three categories, Collagen, Alginates, and Foams.

Collagen is the most abundant protein in your body. It’s involved with all aspects of wound healing. Using dressing embedded with collagen encourages the body to form new collagen fibers and support the growth of new tissue. Collagen dressings most often come in sheets and in powder form.

For wounds that may be draining, I’d consider using an alginate dressing. An alginate dressing is formed from seaweed and is capable of absorbing moisture. When moisture interacts with the dressing, it forms into a gel that supports the healing of the foot ulcer because it requires moisture to
be reactive. It’s not used on dry wounds.

The final category of conventional wound products are foams. Foams are indicated for wounds that have even heavier drainage. Sometimes
they’re used as a primary dressing directly on the wound. Other times, they’re used as a secondary dressing to absorb more moisture if necessary.

These are just the broad categories. Within each is a tremendous number of products that are available. There’s no one-size-fits all solution for a
diabetic foot ulcer. If these aren’t providing results, there’s more that can be done. In next week’s video, I’ll discuss more advanced dressings for diabetic foot ulcers.

#DiabeticFootUlcer #FootUlcerTreatment #DFU

00:00 Introduction
01:05 Why you should inspect your feet nightly if you are diabetic
01:35 What is a diabetic foot ulcer?
02:15 How a diabetic foot ulcer is assessed
03:46 Choosing the right wound dressing for your diabetic foot ulcer
06:16 How to connect with Houston Podiatrist
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  1. AHM

    There is a shoe insole, Podophylus, that has worked great in drying foot wounds quickly. Etsy has it. No infection no amputation…

  2. adija

    thank God I was able to locate Dr adule on YouTube who was able to eliminate my type one diabetes totally with his herbal medicine

  3. Geezer D Luffy

    My dad has an ulcer on the ball of his foot where you form alot of calluses and he owns a construxtio conpany working 8-10 hours day so there's pressure on it alot. It's really dry and about the size of the tip of your pinky he can't really afford yo keep going back to a podiatrist at the moment. Since it's pretty dry should he use a collagen dressing with some type of wound gel on it? I keep telling him to dress it and keep it moist cause it won't with dead dried out callus all around it and he's the type that won't take it seriously unless he hears from a dr he's going to lose his foot. Any insight or help on how to treat and dress his foot would be greatly appreciated


    My heart just keeps thanking you and thanking you Dr Igudia for all you have done for me, you gave me your words that you could heal any sickness or disease, thank you for permanently curing me of my Type 2 diabetes you are amazing.

  5. Rachel Dawson

    Thank goodness for Giving me a Quick Recovery From Diabetes and / Arthritis Disease, Thank you Drdodoyi On YouTube…

  6. Rachel Dawson

    Thank goodness for Giving me a Quick Recovery From Diabetes and / Arthritis Disease, Thank you Drdodoyi On YouTube…

  7. Arne Larsen

    I’m amazed no mention of treating wound with ozone. Cleaning wound with ozonated saline, topical ozonated oil and limb bagging with ozone. Secondly restore blood circulation using EWOT if patient can use an exercise bike.

  8. wali rahman

    Sir dr wali from kuwait,nationality pakistani, working in kuwait in diabetic foot care unit from last 6 months..basically i m general surgeon .i want to do specialized training in diabetic wound care.. is there any training programme with u???

  9. Drdodoyi

    Only one thing I'm assure of about the natural HERB'S for cures 💯 Drdodoyi on YouTube is a blessing to me and my entire household..

  10. Barb Ladner

    Hello I have an ulcer at the bottom of my foot ended up with for surgeries on the foot with an infected bone I am not a diabetic I am on a wound vac I see a foot and ankle doctor first gentleman did not do anything he just put me in a boot and they also proceeded to get bigger and here I am a year later still getting surgery done on my foot but I am not a diabetic they cannot figure out why I ended up with an ulcer I have previous surgery 5 years ago to toe's amputated and four inches of bone taken out and right now I am on a wound vac but they are still stumped and why I have this foot ulcer it's not pretty but I just like a lot of people they get houses at the bottom of the feet and they're not diabetics but it's been a rough year for this to close up but I tell everybody don't give up hope it will get better but like I said I am one a wound VAC again but tell a lot of people don't give up it is hard but you'll get through it

  11. Jacqui Basheer

    Thank you for this information. I am curious to know what your opinion is of silver wound dressing?

  12. akash kadam

    Vac machine therapy helps,it will heal

  13. Aaron Mohr

    I am dealing with non-healing wounds on both feet…. and not diabetic

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