What is the Best Way to Dress Your Diabetic Foot Ulcer?

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A Diabetic foot ulcer is one of the most concerning complications of diabetes. The open wound put the foot at risk for developing an infection.
That infection can travel to the bone. A bone infection put you at risk for needing an amputation to stop its spread. My job is to stop that from happening.

If you have developed a diabetic foot ulcer, it's essential that you get it treated. It's not a simple injury like a cut it's a serious, life and limb
threatening situation that requires professional guidance to get it healed without worsening. Depending on the character of the wound, it is going to require different dressings. There's not a one-size-fits all dressing that is
right for all diabetic foot ulcers.

First, let's talk about what not to do. Do not use alcohol or hydrogen peroxide to disinfect the wound. Both of these are too caustic and, while they do kill all the bad stuff that might be infecting the wound, they also kill all the good stuff that you need to heal the foot ulcer. The same goes for betadine, unless you're specifically instructed to use it by your podiatrist or wound care physician.

The dressings that you are going to use for your diabetic foot ulcer will be determined by how dry the wound is or by how much it is draining. Let's start with the driest of wounds. Otherwise known as dry gangrene. This is a little bit of a trick, since I recommend just a dry dressing if your foot is like this. Using any ointment, even an antibiotic ointment can cause this dry gangrene to become wet and spread. Gangrene is a sign of tissue necrosis, and is a sign that there's not enough circulation to the foot. I may do a circulation test in the office and will likely refer you to another physician to assess your circulation. You may require a procedure to restore circulation. In some cases, this can resolve the gangrene in many, however, it is too late and we'll need to treat this surgically.

For all other wounds, the goal is to provide an ideal wound-healing environment. If the wound is dry, you will want a dressing that adds moisture. If the wound is draining, you want a dressing that will absorb
the excess drainage and keep it away from the wound. A dry non-wound will respond well to a dressing with a hydrogel. A hydrogel mostly is composed of water. It functions to moisture to a dry wound and encourage it to heal. Hydrogels don't irritate the surrounding skin and don't adhere to the surface of the wound. They promote wound epithelialization as they partially mimic the structure of the skin and encourage wound healing. Hydrogels are available in gel form. You'll also find them impregnated in gauze.

A diabetic ulcer that is only draining a little bit will be ideal for a collagen dressing. These come in sheets or in powder form. The collagen interacts with the wound drainage and converts into a gel. Collagen plays an important role in wound healing. By using a dressing with collagen, It adds this vital component to the wound, where it serves as a scaffold to complete wound healing to occur.

When there is moderate to heavy drainage coming from the wound, it is often too much for a collagen dressing to absorb, leading to maceration of the wound. In these cases, we need to use something more absorbent to keep the wound drier. The best dressings for wounds, such as these are alginates and foams.

An alginate dressing is derived from seaweed. They are highly absorbent
and non-adherent to the wound. Some alginates are impregnated with silver for a greater antimicrobial effect. Alginates are available in sheets and ropes, making them versatile to work wherever the wound is located. The alginate dressing absorbs the exudate from the wound and forms into a gel. Alginates provide a moist wound environment by managing the drainage. They are capable of absorbing up to 20 times their weight.

Another choice for a moderate to heavily draining wound are foam dressings. Foam dressings can be used as a primary dressing directly on the wound, or a secondary dressing over one of the other dressing types to absorb more moisture. Foam dressings are so absorbent that they can be used in draining, non-infected wounds for several days.

#DiabeticFootUlcers #WoundDressings #HelpMeHealMyUlcer

00:00 Introduction
01:35 What NOT to treat your wound with
02:09 Dressing a wound with Dry Gangrene
02:53 Principles of choosing a dressing for your Diabetic Foot Ulcer
03:08 Dressing a dry wound using a hydrogel
03:44 Using a collagen dressing for a mildly draining wound
04:28 Using an alginate dressing for a draining wound
05:04 Using a foam dressing for a draining wound
06:04 How to work with Houston podiatrist Dr. Andrew Schneider