When Diabetic Foot Ulcers Can Be Managed At Home

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In this photo, one can see the same wound after three weeks of home care.
Here is the same wound after six weeks of home care.
A 60-year-old patient, who has had type II diabetes for over 20 years, presented with an infected deep necrotic ulceration of the hallux. The author performed a hallux and partial first metatarsal amputation to stabilize the acute, limb-threatening infect
By Ronald A. Sage, DPM

Approximately 15 percent of all patients with diabetes can be expected to develop ulceration in their lifetime, thus putting them at risk for lower extremity amputation. Treatment for infected diabetic foot wounds accounts for one quarter of all diabetic hospital admissions in the United States and Great Britain.1-3 Patient education, proper footgear and regular foot examination can decrease the frequency and severity of ulceration.
However, when ulceration does occur, home care may be a cost-effective intervention that can either avoid or shorten hospital admissions in appropriate cases.
Obviously, severe, limb-threatening infection or ulceration requires hospital care. This is especially true in cases complicated by vascular disease that may require angiography and bypass surgery. However, if acute infection has been stabilized and the patient has adequate vascular perfusion (or it has been restored during hospitalization), proper wound care at home can facilitate the completion of wound closure. Such care does require administration of necessary antibiotics, debridement and dressing changes, offloading the ulcerated part, and optimal diabetes management.

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