This articles gives an informative overview of ischemic ulcers that are associated with diabetes mellitus
An ischemic ulcer is a break or opening in the skin occurs due to a reduced blood flow to the area. This article takes a brief look at ischemic ulcers that are associated with diabetes mellitus.
The initial opening of the ulcer may be caused due to injury. However, the failure to heal is due to an insufficient blood supply. The reduced blood supply is caused by peripheral arterial disease, which can be due to underlying diabetes mellitus.
Patients with ischemic ulcers generally have symptoms of peripheral arterial disease. These can include cold feet, pale skin, loss of hair on the legs, and the presence of an ulcer. On examination, the foot pulses are very weak, and the ulcer appears raw, with occasional signs of an infection.
In patients with diabetes, ischemic ulcers are diagnosed by their clinical appearance and the lack of strong peripheral pulses. An ankle brachial pressure index test will reveal the presence of poor blood flow to the ulcer.
Additional tests, such as an x-ray, may be performed to ensure the ulcer has not extended deep enough to involve the underlying bone.
It is essential that blood sugars are adequately controlled through diet and drug treatment. Patients may be advised to rest and wear comfortable, customized footwear that does not irritate the ulcer in any way. Foot hygiene is also important, and the ischemic ulcer should be kept clean. Special dressings are available to ensure the wound remains sterile so that no infections develop.
In the event of the development of an infection, antibiotic treatment may be required. In more severe cases of ischemic ulcers, surgical treatments such as an arterial bypass may need to be performed to improve blood flow to the peripheries. Sometimes, high-pressure oxygen, or hyperbaric oxygen, treatment may be useful. If the ischemic ulcer is in a steady state and is clean, skin grafts or tissue grafts may be applied as treatment.
Certain simple steps can be followed to prevent complications of ischemic foot ulcers in patients with diabetes. These include carefully inspecting the foot ulcer every day, cleaning the ulcer with soap and water, wearing comfortable footwear and applying a moisturizer regularly. The most important measure is to maintain optimal blood sugar levels in the blood. Patients with this condition are strongly advised to stop smoking.