Rome, GA Foot Doctor
 

Conditions We Treat

Ulcerations, Open Sores of the Skin

Ulcerations are a result of a break down of the skin. Ulcerations are classified based upon their depth and their cause. Common ulcerations are due to diabetes, ischemia (poor circulation), and venous stasis (varicose veins).

Diabetic ulcerations are by far the most common form of ulceration of the feet. These ulcerations occur in areas of the foot that are exposed to excessive pressure or irritation from the rubbing of the shoes on the skin. corns and calluses develop as a result of excessive pressure over bony areas of the foot. Over time the thickened callus that forms can act as an irritant that breaks down the skin under the callus, forming an ulceration. This is more likely to occur if the person with diabetes also suffers from diabetic neuropathy. Diabetic neuropathy is a condition that most commonly affects the nerves of the hands and feet. Diabetic neuropathy causes a loss or alteration in the ability to perceive pain associated with excessive pressure, heat or cold, sharp and dull, vibration and position sense. As a consequence, corns and calluses which would normally be painful do not cause pain and over time, breaks down the skin causing ulceration. Quite often, an infection will also occur which can result in bone infection (osteomyelitis) or deep tissue infection. If the person also has poor circulation, gangrene can develop.

Treatment is geared toward prevention. People with diabetes must learn to inspect their feet daily and obtain medical attention as soon as they notice anything suspicious or an ulceration forming. Calluses which have a black or blue appearance are in the early stages of ulceration. Corns and calluses should be treated regularly by a podiatrist. These areas should be protected from pressure by using pads and/or cushions. Over-the-counter corns removers must be avoided. These home treatments have acid in them, which can burn the skin and cause infection. Once an ulceration has started, every effort must be made to reduce the pressure to the area or it will not heal. Special shoe inserts, called orthotics, are useful in reducing abnormal pressure on the bottom of the foot in areas of calluses or ulcerations. There are also several different topical medications that are used for the treatment of ulcerations. Treatment should be guided and supervised by a physician.

Ischemic ulcerations occur in areas of poor circulation. Commonly they form on the feet, ankles and lower legs. As the circulation gets worse, the skin begins to thin and is less resistant to pressure and friction forces. Spontaneous break down of the skin can occur. These ulcerations tend to be painful, with a whitish or light-pinkish base. Treatment is focused on keeping the ulceration clean and free from infection. By-pass surgery may be indicated to improve the circulation to the area. Hyperbaric oxygen treatments may also be useful. It is important not to use bandages that can cut off the circulation, or adhesive tape, which can tear the skin when removed.

Venous stasis ulcerations occur in areas where the venous circulation is poor. Venous circulation is the blood flow that returns to the heart in the veins. Varicose veins are abnormal veins that do not allow normal blood flow back to the heart. As the veins become more and more damaged, there is a pooling of fluid that accumulates in the feet and ankle. This swelling of the tissue, over time will cause damage to the skin, and can result in open sores or ulceration. These ulcerations tend to weep a clear fluid, have a reddish base and become infected easily.

Treatment is geared toward prevention by reducing the swelling in the legs with the use of support stockings, medications to reduce the swelling, and elevation of the legs. Once ulcerations have developed, treatment consists of keeping the ulcerations clean and free from infection. This often requires the long-term use of oral antibiotics. A common form of treatment consists of wrapping the legs with a dressing called an unna boot. This dressing is a gauze wrap which has xinc oxide impregnated in it. This dressing helps to keep the bacteria that is in the ulceration from growing and also adds compression to help reduce swelling.

Article provided by PodiatryNetwork.com.

We make every effort to inform you of the most current and newest treatments available on this website. Unfortunately, technology changes rapidly in health care and in some circumstances our doctors may recommend treatments or diagnostic testing different than those outlined in our website.

  Back to Top   



 
Free Podiatry Book Request for local Residents
Local residents can click here to receive your free book, "Healthy Feet For Life" written by Dr. Brian K. Middleton.
  Free Podiatry Book Request
Request an Appointment
Use the convenience of our website to request an appointment and save a few extra "steps"
  Request an Appointment
Ask-the-Doctor Videos
Click here for answers to your most frequently asked questions.
  Ask-the-Doctor Videos
New Patient Forms
Download and print our new patient registration and medical history forms.
  New Patient Forms
Laser Treatment For Toenail Fungus
This therapy focusing intense laser light beams right on the fungus.
  Laser Treatment For Toenail Fungus
Heel Pain Center
We have a large armamentarium of treatment options for dealing with heel pain.
  Heel Pain Center
Universal Ultrasound
We use sonography for diagnoses of plantar fasciitis, tendonitis, neuromas, cysts and certain tumors.
  Universal Ultrasound
Specialized Services
Dr. Middleton strives to provide the best possible foot care to his patients.
  Specilaized Services
Join us on Facebook
Join us on Instagram
Ask-the-Doctor Videos
Check out our YouTube Channel
Google+
Pin Us
Follow us on Twitter
Follow our Blog