Foot Wounds and What They Could Mean
Foot wounds can have many causes and significant consequences if care is improper or delayed.
What is a foot wound?
Foot wounds, also known as a foot ulcer, are breaks in the skin creating an opportunity for bacteria to enter and get into the tissue and bone. This may occur from an accident like a direct trauma or it may indicate an underlying disease, like a blood flow issue.
What are the most common types of foot wounds podiatrists see?
The most common types of foot wounds podiatrists see are
Diabetic foot ulcer
Venous stasis ulcer
Arterial ulcer
Their causes may start similarly but what keeps them from healing is essential to understand. A foot wound may start from accidentally stepping on a nail, hitting the leg against a thorn bush, or a turkey pecking at your legs (these are all true stories!).
A diabetic foot ulcer (DFU) is defined as a wound on the foot that happens in the presence of diabetes. The challenge with healing DFUs may be from nerve damage, a circulation problem, an infection, or a combination of all three. When a person with diabetes has nerve damage, they may not be able to detect a problem to seek immediate attention. When the wound is on the foot, they may continue to walk on it, which delays healing. It is not uncommon to have some level of circulation issues in those with diabetes, affecting the healing process as well. Managing blood sugars can decrease complications of wound healing.
A venous stasis ulcer (VSU) is a wound that can occur anywhere on the legs, ankle, and/or foot. It is a consequence of the veins not being able to pump blood back to the heart like it’s supposed to. Veins are different from arteries in that veins have a valve that pushes against gravity to return blood to the heart and the walls are thinner (compressible). Whereas arteries deliver blood from the heart to the legs. When blood pools in the legs, there is increased pressure leading to swelling and causing the skin to break open or not heal.
An arterial ulcer may start from an injury, like bumping into furniture, but it turns black rather than healing as normal tissue because there isn’t enough blood flow to reach the injured area. Blood provides essential nutrients to heal damaged tissue so if not enough blood reaches the injured site, the tissue can die and become gangrene. Think of the artery as a tree branch that delivers water to grow leaves. When there is a drought, the branch will shrivel and die. Decreased blood through the artery can be caused by the arterial vessels narrowing, either by thickening of the arterial wall or from plaques that restrict blood flow to tissues.
Why is it concerning?
Foot wounds that do not heal in a timely manner are concerning because the longer they remain open, the higher the chances of it becoming painful and infected. It may also indicate underlying issues like infection, bony pressure points, circulation problems, or nutritional deficiencies. Early intervention is essential to minimize complications.
When to seek professional help?
Cuts, wounds or ulcers that fail to heal after 2 weeks should be brought to your doctor’s attention. If there is redness, swelling, pain, or drainage, or looks generally abnormal, do not ignore it. A podiatrist can help manage wounds that are not healing and send the appropriate referrals for additional workup. Improper home care or delayed professional help can have devastating consequences ranging from delayed healing to worsening infection, or amputation. Podiatrists are specially trained to care for the foot and ankle and collaborate with your doctors and specialists. A referral to a vascular specialist may be necessary if there is a concern with the circulation.
Conclusion
Foot wounds that fail to heal right away can give us a lot of insight into a person’s general health. Podiatrists can help alleviate pressure points that may be preventing the foot ulcers from healing and collaborate with other specialists to ensure wounds are properly cared for. Not all foot wounds should be soaked or have antibiotic ointment applied. The best course of action is to contact your doctor right away and keep the area dry and clean until further instructions are provided.
