Understanding Diabetic Wounds – Diabetic wounds, also known as diabetic foot wounds, are open wounds on the skin that usually occur in diabetic patients. This condition is common because diabetes can cause nerve damage and poor blood flow, making it more difficult for wounds to heal.
Diabetic wounds are also known as chronic complications of diabetes. Diabetes patients have a high risk of developing foot injuries because high blood sugar levels can damage blood vessels and nerves in the feet. As a result, wounds will be difficult to heal because the blood supply and nutrients to the wound area are reduced. Apart from that, diabetes patients can also experience numbness in their feet, so they don’t realize there is an injury until the injury becomes serious.
Causes of Diabetic Wounds
Diabetic wounds are generally caused by 3 main things, namely:
Neuropathy or nerve damage in diabetes sufferers can cause loss of sensation of pain and touch. This makes sufferers unaware of injuries or irritation in certain areas. Neuropathy can also cause deformity of the feet, increasing the risk of injury.
Vasculopathy is damage to blood vessels due to diabetes. Poor blood flow to certain areas causes slow wound healing. Lack of blood supply also increases the risk of infection and other complications.
Diabetes can weaken the immune system making it difficult to fight infections. This weak immune system also slows down the wound healing process.
The three things above interact with each other and contribute to the formation of diabetic foot wounds that are difficult to heal. Therefore, it is very important for diabetes sufferers to keep blood sugar levels under control.
Risk Factors for Diabetic Wounds
Several risk factors that can increase a person’s chances of developing diabetes wounds include:
Diabetic wounds are more common in people over 60 years of age. As you get older, the risk increases due to changes in the skin and blood vessels.
- The duration of diabetes is high
The longer a person suffers from diabetes, the higher the risk of complications such as diabetic wounds. This is related to damage to blood vessels due to uncontrolled blood sugar levels in the long term.
- Poor blood sugar control
Uncontrolled blood sugar levels can damage blood vessels and nerves. This causes blood circulation and the sensation of pain to decrease, making it difficult for wounds to heal.
Smokers have a 4 times higher risk of developing diabetic foot wounds than non-smokers. Cigarette smoke can constrict blood vessels and interfere with wound healing.
Areas Frequently Affected by Diabetes Wounds
Diabetic wounds most often occur on the feet and calves. The most vulnerable area is the toes. This is because poor blood circulation in the lower extremities in diabetes sufferers can make it difficult for wounds to heal.
Apart from that, peripheral neuropathy which is often experienced by diabetes sufferers also reduces sensation in the feet. As a result, a person may not be aware of a small wound on the foot which then worsens into a diabetic wound.
Repeated pressure and friction on the soles of the feet when walking is also prone to causing injuries. The tips of your toes that touch your shoes tightly are also at high risk of injury. Therefore, it is very important for diabetes sufferers to check their feet regularly every day.
Classification of Diabetic Wounds
There are several ways to classify diabetic wounds, including:
- According to Wagner
The Wagner classification is divided into 6 grades:
– Grade 0: no ulcers/open wounds
– Grade 1: superficial wounds involving the entire skin
– Grade 2: wounds extending to subcutaneous tissue
– Grade 3: muscles, tendons, or bones affected
– Grade 4: gangrene of the toes or part of the foot
– Grade 5: gangrene of the entire foot
- Based on the University of Texas
The University of Texas classifies diabetic wounds into 4 stages:
– Stage A: no infection or ischemia
– Stage B: infection occurs
– Stage C: ischemia occurs
– Stage D: infection and ischemia occur simultaneously
This classification is important for determining appropriate treatment for diabetic wound sufferers.
Common Symptoms of Diabetic Wounds
Diabetic wounds have several general symptoms to watch out for. Some of them are:
- Wounds do not heal
Wounds in diabetes sufferers have a high risk of not healing for a long time. Even though it has been treated, the wound often does not dry out and heal completely.
- Redness of the skin
The area around the wound often appears reddish. This indicates infection and inflammation in the wound area.
Diabetic wounds are also often accompanied by swelling around the wound. This is the body’s reaction to infection and inflammation.
Pain and soreness are also commonly felt in diabetes wounds. This pain can be mild to severe, depending on the severity of the injury.
Some diabetes sufferers also experience numbness or numbness around the wound. This is caused by nerve damage due to diabetes.
Infected wounds usually also produce yellowish pus. Pus indicates that the wound has been contaminated with germs.
The appearance of these symptoms indicates that wounds in diabetes sufferers are at risk of becoming complex and difficult to heal. Immediately consult a doctor if you experience these symptoms to get appropriate treatment.
Diabetes Wound Complications
Diabetic wounds that are not treated properly are at risk of experiencing various serious complications. Some common complications from diabetic wounds include:
Diabetic wounds are very susceptible to infection because the immune system of diabetes sufferers decreases. Infection can quickly spread to surrounding tissue and worsen the wound. Infections that are not treated immediately can be life-threatening.
Gangrene or tissue necrosis occurs when the blood supply to the wound area is blocked so that the tissue dies. This condition commonly occurs in extremities such as toes and requires amputation so that the infection does not spread to healthy areas.
If a diabetic wound is accompanied by severe infection and widespread gangrene, amputation may be necessary to save the sufferer’s life. Amputation is carried out by cutting off the infected part of the body (usually the foot or finger) so that the infection does not spread to vital organs.
The worst complication of diabetic wounds is sepsis or blood infection. This occurs if the infection in the wound is not treated and the pathogen enters the bloodstream, spreading throughout the body. Sepsis can cause organ failure and even death if not treated immediately.
Prevention of diabetic wounds
There are several ways to prevent diabetes wounds, including:
- Controls blood sugar levels
Keeping blood sugar levels under control is very important to prevent diabetes complications such as wounds. Make sure to check your blood sugar levels regularly and follow your doctor’s recommendations regarding diabetes treatment and diet.
- Take care of your feet regularly
Check your feet every day to make sure there are no wounds or changes to the skin. Clean your feet daily with warm water, dry them with a soft towel, and apply moisturizing cream to prevent dry, cracked skin. Trim nails regularly and straight. Avoid walking barefoot.
- Stop smoking
Smoking can worsen circulation and increase the risk of diabetic sores. Therefore, it is highly recommended to stop smoking if you suffer from diabetes.
- Exercise regularly
Regular exercise can help improve circulation and lower blood sugar levels. Consult your doctor about the types of exercise that are safe to do. Avoid exercises that are too heavy which can cause irritation or injury to the feet.
Treatment of Diabetic Wounds
Diabetic wound treatment aims to speed up wound healing and prevent infection. Some common treatments include:
- Cleaning Wounds
Cleaning wounds regularly is very important to prevent infection. Usually, the wound is cleaned every day with a saline solution or clean water. Dirt and dead tissue must be removed to speed healing.
- Local Treatment
Local treatment can be done by applying antibiotic or antiseptic ointment to the wound. Apart from that, doctors can also provide modern treatments such as negative pressure therapy and applying gel to wounds.
- Negative Pressure Therapy
Negative pressure wound therapy (NPWT) involves placing a device on the wound that gently draws fluid out of the wound. This helps stimulate the growth of new tissue and speeds healing.
If an infection occurs, the doctor will give oral antibiotics or an injection to kill the germs that cause the infection. Timely administration of antibiotics is very important to prevent serious complications in diabetic wounds.
Prognosis of diabetic wounds
The healing time for diabetic wounds depends on the severity of the wound. Minor wounds may heal within a few weeks, while serious wounds may take months or even years to heal completely.
Several factors that influence the prognosis of diabetic wounds are:
– Location and extent of wounds – deeper and wider wounds take longer to heal.
– Infection – wounds infected with bacteria or fungi will be difficult to heal.
– Wound care – proper and regular care can speed up healing.
– Control blood sugar – uncontrolled blood sugar can slow wound healing.
– Nutritional and immune status – poor nutritional status and low immune system worsen the prognosis.
– Comorbidities – complications of diabetes or other diseases also affect the speed of healing.
– Age – wounds in elderly diabetes sufferers generally take longer to heal.
With proper attention, regular monitoring, and appropriate treatment, the prognosis of diabetic wounds can improve. However, ignoring diabetes wounds can result in serious complications, including amputation. Therefore, it is important to consult a doctor and follow the recommended treatment guidelines.