Wound care expert Fatima Naqvi, MD, CMD

Q: Why should diabetic wounds be taken more seriously than non-diabetic wounds?

A: Diabetic foot complications are one of the most common complications that lead to hospitalization. In the United States, the lifetime risk of developing diabetes is approximately 40%.

As of 2014, approximately 29.1 million (9.3%) of Americans were said to have diabetes. It is the leading cause of cardiovascular morbidity and mortality, renal failure, blindness and amputation. Prognosis of a foot ulcer is changed dramatically due to the presence of diabetes, because the underlying pathology is not reversible.

Some of the complexities of diabetic wounds are as follows: Previous foot ulcers, non-healing wounds, recurrent infections, previous or pending amputation, recurrent hospitalization, financial burden, and compromised social, psychological or mental health.

Prevention with early detection is the best initial strategy. Risk factors for developing a foot ulcer in patients with Diabetes (Type I and Type II) include: uncontrolled diabetes, smoking history, presence of neuropathy; or its signs and symptoms, previous foot ulcer or amputation, signs of toenail fungal infection or inflammation, dry skin, and other skin abnormality of the foot (e.g., toe webs, bottom of the foot). For example, psoriasis, corns, calluses, blisters and dermatitis can predispose to skin ulcers, presence of bony abnormality, foot/ankle edema (swelling), arterial disease, absence of foot pulses and venous disease.

Perform an appropriate history and physical exam with risk assessment upon admission. Patient-centered standards of practice for foot ulcers, along with early prevention and optimal treatment, are crucial for preventing complications.