DEFINITION OF ELDERLY CARE

ELDERLY CARE

DEFINITION OF ELDERLY CARE

Elderly care is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and home care. Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity.

RESOURCES

• Utah Division of Aging and Adult Services, The Utah Division of Aging and Adult Services (DAAS) provides senior services and adult protective services. DAAS was created as Utah’s State Unit on Aging by Utah statute (62A-3-104) giving the Division the legal authority to establish and monitor programs that serve the needs of Utah’s seniors. The Division is the sole state agency, as defined by the Older Americans Act of 1965 as amended to:
• (1) serve as an effective and visible advocate for the aging and adult population of Utah
• (2) develop and administer a state plan under the policy direction of the Board
• (3) take primary responsibility for state activities relating to the Older Americans Act.
• The Division also administers the Adult Protective Services program to investigate cases of abuse, neglect, and exploitation of vulnerable adults. Trained staff in a statewide system of offices, work with local law enforcement and community partners to educate and assist victims to access appropriate resources within the community.

The AARP Caregiving Resource Center offers expert advice and resources for your senior care needs.  This site will help answer all of your questions and includes:

• Caregiving Tools
• Connect with an Expert
• Find Support
• Find a Provider
• Care for the Caregiver
• Locating Resources
• Caregiving News.

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Newborn Care From All Body

~Face

It's disconcerting to see a newborn with a red, blotchy face, but baby acne is a common and harmless condition.

Care tip: Wash your baby's face daily with a mild baby soap.

~Eyes

Some babies have a yellowish discharge or crusting in the eye or on the lid, which is usually caused by a blocked tear duct. This condition can last several months.

Care tip: Wipe the area using a cotton ball moistened with warm water.

~Scalp

Many newborns develop a scaly scalp condition called cradle cap. It typically disappears in the first few months.

Care tip: Wash your baby's hair with a gentle baby shampoo no more than three times a week and gently brush out the scales daily using a baby hairbrush or soft toothbrush.

~Nose

Babies' narrow nasal passages tend to fill with mucus.

Care tip: Gently unclog nostrils with an infant-sized nasal bulb syringe or try the trauma-minimizing Nosefrida (nosefrida.com). To loosen mucus, insert saline solution with an eyedropper before suctioning.

~Nails

A newborn's nails usually are soft, but they can scratch his sensitive skin.

Care tip: Use baby nail clippers or blunt-nosed scissors. Clip after his bath when nails are soft, or when he's asleep and his fingers are relaxed.

~Skin

Some babies develop red, itchy patches called eczema or atopic dermatitis—an inheritable skin condition.

Care tip: Limit baths to 10 minutes, and use a mild, fragrance-free soap and lukewarm water; liberally apply hypoallergenic skin cream immediately afterward. Stick to cotton clothing.

~Bottom

Too much moisture plus sensitive skin can equal diaper rash for many babies.

Care tip: Change diapers frequently. Rinse your baby's bottom with water during each change and blot dry. Avoid using wipes; they may irritate skin. Barrier creams, such as petroleum jelly or white zinc oxide, may help.

~Umbilical cord

Keep the umbilical cord stump clean and dry; it will shrivel and fall off within a few weeks.

Care tip: Avoid covering the cord area with a diaper and stick to sponge baths until the stump detaches.

~Circumcision

The tip of the penis will be swollen, and a yellow scab will appear.

Care tip: Gently clean the genital area with warm water daily. Use petroleum jelly to protect the site and prevent the penis from sticking to a diaper.

~Legs

Newborns' legs are bowed out and the feet are turned in, which is no surprise, given their previous cramped living quarters.

Care tip: Don't worry about it—your baby's legs and feet will straighten in anywhere from six to 18 months.

~Feet

Newborns' toes frequently overlap and the nails look ingrown (but aren't).

Care tip: Don't sweat it—this appearance is perfectly normal.

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First Aid for Broken Bones and Fractures

What is a broken bone?

TOPNURSE~A broken bone happens when one of your bones becomes cracked or broken into multiple pieces. It’s also known as a fracture. It can result from a sports injury, accident, or violent trauma.

Broken bones usually aren’t life threatening, but they do require immediate medical care. Learn how to recognize the symptoms of a broken bone, provide first-aid treatment, and get professional help.

What are the symptoms of a broken bone?

A broken bone can cause one or more of the following signs and symptoms:

• intense pain in the injured area that gets worse when you move it
• numbness in the injured area
• bluish color, swelling, or visible deformity in the injured area
• bone protruding through the skin
• heavy bleeding at the injury site

How can you provide first-aid care for a broken bone?

If you suspect that someone has a broken bone, provide first-aid treatment and help them get professional care:

• Stop any bleeding: If they’re bleeding, elevate and apply pressure to the wound using a sterile bandage, a clean cloth, or a clean piece of clothing.
• Immobilize the injured area: If you suspect they’ve broken a bone in their neck or back, help them stay as still as possible. If you suspect they’ve broken a bone in one of their limbs, immobilize the area using a splint or sling.
• Apply cold to the area: Wrap an ice pack or bag of ice cubes in a piece of cloth and apply it to the injured area for up to 10 minutes at a time.
• Treat them for shock: Help them get into a comfortable position, encourage them to rest, and reassure them. Cover them with a blanket or clothing to keep them warm.
• Get professional help: Call 911 or help them get to the emergency department for professional care.

If the person doesn’t appear to be breathing, is unconscious, or both, call 911 for medical help and begin CPR. You should also call 911 if:

• you suspect they’ve broken a bone in their head, neck, or back
• the fractured bone has pushed through their skin
• they’re bleeding heavily

Otherwise, help them get to the emergency department by car or other means so a doctor can diagnose their condition and recommend appropriate treatment.

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Surgical Wound

What is a surgical wound?

A surgical wound is a cut or incision in the skin that is usually made by a scalpel during surgery. A surgical wound can also be the result of a drain placed during surgery. Surgical wounds vary greatly in size. They are usually closed with sutures, but are sometimes left open to heal.

What are the types of surgical wounds?

Surgical wounds can be classified into one of four categories. These categories depend on how contaminated or clean the wound is, the risk of infection, and where the wound is located on the body.

Class I: These are considered clean wounds. They show no signs of infection or inflammation. They often involve the eye, skin, or vascular system.

Class II: These wounds are considered clean-contaminated. Although the wound may not show signs of infection, it is at an increased risk of becoming infected because of its location. For example, surgical wounds in the gastrointestinal tract may be at a high risk of becoming infected.

Class III: A surgical wound in which an outside object has come into contact with the skin has a high risk of infection and is considered a contaminated wound. For example, a gunshot wound may contaminate the skin around where the surgical repair occurs.

Class IV: This class of wound is considered dirty-contaminated. These include wounds that have been exposed to fecal material.

What causes surgical wounds?

Surgical wounds are created when a surgeon makes an incision or cut with a surgical instrument called a scalpel. A wide variety of medical circumstances require surgery. The size of a wound depends on the type of procedure and location on the body.

What are the risk factors for surgical wound infections?

Any surgical procedure will create a surgical wound. The likelihood of a wound infection after surgery is between 1 and 3 percent.

Risk factors for developing a surgical wound infection include having other medical issues, such as diabetes or a weakened immune system. Smokers, older adults, and people who are overweight also have an increased risk of infection. Emergency surgeries, abdominal surgeries, and surgeries that last longer than two hours bring a higher risk of infection, too.

What are the symptoms of surgical wound infections?

Surgical wounds are frequently monitored to make sure they are healing properly. Infections may affect only the skin, tissue under the skin, or implants, according to the Centers for Disease Control and Prevention. Signs of a surgical wound infection include:

• increased pain and redness around the wound
• delayed healing
• the presence of pus
• a foul smell, or drainage from the wound

In some cases, an infected surgical wound can appear dried out or deeper. Fever may also be a common symptom.

How are surgical wound infections diagnosed?

A physician can diagnose a surgical wound infection by examining the wound, assessing symptoms, or taking a culture of fluid drained from the wound.

How is a surgical wound treated?

Treatment for a surgical wound sometimes depends on where it’s located on the body. Surgical dressings are normally placed over the wound and may need to be changed regularly. The skin around the surgical wound will likely need to be cleaned, often with salt water and soap. The wound may also need to be irrigated with salt water. This involves filling a syringe with salt water and spraying the skin around the wound.

Home care

Home care for a surgical wound may involve some of the same procedures, including frequent dressing changes and cleaning. Over-the-counter pain medication can also reduce discomfort. Often, patients are discharged from the hospital before a surgical wound has completely healed. It is essential that patients follow all at-home care instructions. Following directions properly will promote healing and decrease chances of an infection.

What are some complications of surgical wounds?

When surgical wounds cause infection, it typically occurs within 30 days of surgery. Infections may be red, painful, hot to the touch, or drain pus. To treat infections, your physician may prescribe an antibiotic, or they may have to open the wound to clean it.

What is recovery like for surgical wounds?

Recovery varies and can last for weeks to months. Your surgeon should be able to give you specific information on when you can go back to work, exercise again, and return to your daily routine.

What is the outlook for surgical wounds?

The outlook for a surgical wound that is properly healing is good. Following infection control recommendations can increase the chances that the wound heals well.

Source 

https://www.healthline.com

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Surgical wound care

Surgical wound care - open

   

TOPNURSE~An incision is a cut through the skin that is made during surgery. It is also called a surgical wound. Some incisions are small, others are long. The size of the incision depends on the kind of surgery you had.

Sometimes, an incision breaks open. This may happen along the entire cut or just part of it. Your doctor may decide not to close it again with sutures (stitches).

What to Expect at Home

If your doctor does not close your wound again with sutures, you need to care for it at home, since it may take time to heal. The wound will heal from the bottom to the top. A dressing helps absorb drainage and keep the skin from closing before the wound underneath fills in.

Proper Handwashing

It is important to clean your hands before you change your dressing. You can use an alcohol-based cleanser. Or, you can wash your hands using these steps:

• Take all jewelry off your hands.
• Wet your hands, pointing them downward under warm running water.
• Add soap and wash your hands for 15 to 30 seconds (sing "Happy Birthday" or the "Alphabet Song" one time through). Clean under your nails also.
• Rinse well.
• Dry with a clean towel.

Removing the Old Dressing

Your health care provider will tell you how often to change your dressing. To prepare for the dressing change:

• Clean your hands before touching the dressing.
• Make sure you have all the supplies handy.
• Have a clean work surface.

Remove the old dressing:

• Carefully loosen the tape from your skin.
• Use a clean (not sterile) medical glove to grab the old dressing and pull it off.
• If the dressing sticks to the wound, wet it and try again, unless your provider instructed you to pull it off dry.
• Put the old dressing in a plastic bag and set it aside.
• Clean your hands again after you take off the old dressing.

Caring for the Wound

You may use a gauze pad or soft cloth to clean the skin around your wound:

• Use a normal saline solution (salt water) or mild soapy water.
• Soak the gauze or cloth in the saline solution or soapy water, and gently dab or wipe the skin with it.
• Try to remove all drainage and any dried blood or other matter that may have built up on the skin.
• DO NOT use skin cleansers, alcohol, peroxide, iodine, or soap with antibacterial chemicals. These can damage the wound tissue and slow healing.

Your provider may also ask you to irrigate, or wash out, your wound:

• Fill a syringe with salt water or soapy water, whichever your doctor recommends.
• Hold the syringe 1 to 6 inches (2.5 to 15 centimeters) away from the wound. Spray hard enough into the wound to wash away drainage and discharge.
• Use a clean soft, dry cloth or piece of gauze to carefully pat the wound dry.

DO NOT put any lotion, cream, or herbal remedies on or around your wound, unless your provider has said it is OK.

Putting on the New Dressing

Place the clean dressing on the wound as your provider taught you to. You may be using a wet-to-dry dressing.

Clean your hands when you are finished.

Throw away the old dressing and other used supplies in a waterproof plastic bag. Close it tightly, then double it before putting it in the trash.

Wash any soiled laundry from the dressing change separately from other laundry. Ask your provider if you need to add bleach to the wash water.

Use a dressing only once. Never reuse it.

When to Call the Doctor

Call your doctor if:

• There is more redness, pain, swelling, or bleeding at the wound site.
• The wound is larger or deeper, or it looks dried out or dark.
• The drainage coming from or around the wound increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus).
• Your temperature is 100.5°F (38°C) or higher.

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6 Key Factors in Treating a Diabetic Wound

TOPNURSE~By 2030, it is estimated that more than 550 million people around the world will have diabetes. Approximately 25% of these diabetic patients will develop foot ulcers during their lifetime, which often require advanced diabetic wound treatment to prevent complications. To help achieve the optimal healing environment and protect against problems, there are six key factors to consider when treating diabetic wounds.

1. Wound Assessment

Diabetic wounds fall into three categories: neuropathic, ischemic, and neuroischemic. Knowing the distinct features of each wound category is essential to identifying wound progression, infection, and healing. Failure to properly identify the type of wound that exists can lead to an ineffective diabetic wound treatment plan, causing long-term complications or amputation.

2. Tissue Debridement

Wound debridement, or the removal of necrotic tissue from a wound, will reduce pressure, stimulate wound healing, allow for the inspection of underlying tissue, help with secretion or wound drainage, and optimize a wound dressing’s effectiveness. Clinicians typically recommend sharp debridement by scalpel or scissors, but there are other tissue-removal treatments they may recommend, including larval, autolytic, and ultrasonic.

Only an experienced practitioner who knows which section of the tissue to remove without damaging blood vessels, nerves, or tendons should perform a debridement procedure. Understanding the importance of debridement to your diabetic wound treatment plan is often essential with advanced diabetic wounds.

3. Infection Control

Infections are the top concern in any diabetic wound treatment plan. Due to the high morbidity and mortality rates associated with diabetic wounds, more aggressive forms of infection control are necessary. Both oral and topical antibiotics are recommended for all diabetic wound treatment patients who show signs of infection, even mild ones. Topical antimicrobials can reduce bacteria, protect against further contamination, and prevent the spread of infection deeper into the wound. Typical wound dressings used in treating diabetic wounds are those impregnated with antimicrobial agents to help fight infection. Clinicians often prescribe advanced wound care dressings that include silver, iodine, medical-grade honey, or polyhexamethylene biguanide (PHMB) which work to enhance healing by keeping your wound moist.

4. Moisture Balance

Choosing the optimal dressing for a diabetic wound is essential to successful wound healing. The proper wound dressing will help maintain a balanced moisture environment (not too wet or too dry) and allow the wound to drain and heal properly. The location of the wound will also be taken into consideration by your clinician when they choose a dressing. While each wound needs to be assessed properly, some common dressings that can be used for diabetic wounds include alginates, hydrocolloids, and films.

5. Pressure Offloading

For most diabetic wound treatment plans for patients suffering from foot or leg ulcers, pressure reduction or offloading is a key factor in preventing complications. A non-removable total contact cast (TCC) redistributes pressure evenly throughout the lower leg and can reduce healing times. However, TCC is not always the best choice, especially for infected wounds, so other removable offloading devices may be used including removable cast walkers, Scotchcast boots, or healing sandals.

The most common problem with healing when using removable devices is that some patients do not wear them properly, which can delay wound healing. In these cases, studies have found that patients with removable offloading devices only wear them less than 30% of the day. If you have questions about how to utilize offloading devices, speak with your doctor.

6. Underlying Factors

A diabetes wound patient must be treated holistically in order to identify underlying issues and reduce risk factors that are causing wounds in the first place. Achieving control of diabetes is difficult but essential, especially concerning blood glucose levels, proper nutrition, high blood pressure, and smoking cessation. Other factors, such as proper footwear and adequate blood supply to extremities, need to be assessed. No matter the level of injury, a clinician specializing in this field should prescribe a diabetic wound treatment plan.

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How does diabetes affect wound healing?

Diabetes can cause wounds to heal more slowly. This raises the risk that someone with diabetes will develop infections and other complications.

A person who manages their diabetes well can improve wound healing and reduce the chances of developing a serious infection.

Diabetes and wound healing

Those with diabetes may find that different types of wounds are slow to heal.

TOPNURSE~Minor wounds, cuts, and burns are a part of life, but for people with diabetes, they can cause serious health issues.

Many people with diabetes develop wounds that are slow to heal or never heal. Wounds that do not heal well can become infected.

An infection can spread locally, to surrounding tissue and bone, or to further away areas of the body. In some cases, they may even be fatal.

Diabetic foot ulcers affect 15 percent of people with diabetes. These are painful sores that can ultimately lead to foot amputation.

Even when a wound does not become infected, it can affect a person's health and quality of life. Cuts or injuries on the feet or legs can make it difficult to walk or exercise without pain.

Keeping diabetes under control can reduce the risk of slow-healing wounds and complications, including foot ulcers.

A 2013 study found a clear correlation between blood glucose and wound healing. People undergoing surgery for chronic diabetes wounds were more likely to fully heal if their blood glucose was well-controlled at the time of surgery.

Why does diabetes affect wound healing?

Diabetes makes it more difficult for the body to manage blood glucose levels. When blood glucose remains chronically high, it impairs the function of white blood cells, resulting in an inability to fight bacteria.

Diabetes, particularly if uncontrolled, is also associated with poor circulation. As circulation slows, red blood cells move more slowly. This makes it more difficult for the body to deliver nutrients to wounds. As a result, the injuries heal slowly, or may not heal at all.

Nerve damage is another factor affecting wound healing. Uncontrolled blood glucose can damage the body's nerves, which means that people with diabetes may sustain trauma to their feet more easily without being aware that they are injured. This can prevent them from seeking treatment, allowing a wound to become even worse.

Impaired sweating, dry and cracked skin, toenail infections, and foot deformities are more commonly found in people with diabetes, increasing the risk of a bacterial infection.

Research is consistently uncovering other ways that diabetes affects wound healing, including:

• weakened production of hormones associated with growth and healing
• decreased production and repair of new blood vessels
• weakened skin barrier
• decreased collagen production

Complications

People who exhibit poor wound healing due to circulatory and neurological effects of diabetes may have other complications as well. These include heart disease, kidney disease, and eye problems.

A wound left untreated may become infected, and the infection may spread locally to muscle and bone. This is called osteomyelitis.

If the infection spreads into the bloodstream, it is called sepsis and can be life-threatening. Deep infections may sometimes become severe and require amputation.

Prevention

Maintaining good foot hygiene by washing and moisturizing daily may help to promote wound healing.

Strategies that can prevent slow-healing wounds due to diabetes include managing blood glucose, proper foot care, and treating wounds promptly.

Proper foot care includes:

• washing feet daily
• patting dry and applying moisturizing lotion
• avoiding walking barefoot
• carefully trimming toenails
• wearing comfortable shoes
• inspecting feet and looking inside shoes daily
• having a doctor check feet at each visit

People with diabetes should carefully monitor their wounds. While it is normal for diabetic wounds to heal slowly, it is not normal for them to remain open for several weeks, to spread or ooze, or to be extremely painful.

People with well-managed diabetes are less likely to suffer from serious wounds that do not heal.

People with type 1 diabetes must take insulin for life. Those with type 2 diabetes have more options for controlling their blood glucose, including several anti-diabetic drugs and insulin.

Both types of diabetes benefit from a carb-controlled diet. In the case of type 2 diabetes, lifestyle interventions, such as diet, exercise, and weight loss, may substantially improve blood sugars and may even allow a person to manage their diabetes without medication.

Outlook

A wound that does not heal can quickly become life-threatening. A positive outlook for slow-healing wounds depends on receiving prompt treatment.

People with diabetes should immediately contact a doctor when they develop serious or painful wounds, or if a wound appears infected, causes a fever, or does not heal after several days.

A combination of aggressive antibiotic treatment, cleaning the wound, surgical treatment to remove dead tissue, and better glucose control can help. If the wound does not respond to treatment, such as with a severe or extensive diabetic foot ulcer, amputation may be necessary.

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What is a Diabetic Foot Ulcer?

What is a Diabetic Foot Ulcer?

TOPNURSE~A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.

Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable.  

Causes

Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.  

Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain, and one may not even be aware of the problem. Your podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament.

Vascular disease can complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection. Elevations in blood glucose can reduce the body's ability to fight off a potential infection and also slow healing. 

Symptoms

Because many people who develop foot ulcers have lost the ability to feel pain, pain is not a common symptom. Many times, the first thing you may notice is some drainage on your socks. Redness and swelling may also be associated with the ulceration and, if it has progressed significantly, odor may be present.

When to Visit a Podiatrist

Once an ulcer is noticed, seek podiatric medical care immediately. Foot ulcers in patients with diabetes should be treated to reduce the risk of infection and amputation, improve function and quality of life, and reduce health-care costs.

Diagnosis and Treatment

The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection.

There are several key factors in the appropriate treatment of a diabetic foot ulcer:

• Prevention of infection
• Taking the pressure off the area, called “off-loading”
• Removing dead skin and tissue, called “debridement”
• Applying medication or dressings to the ulcer
• Managing blood glucose and other health problems

Not all ulcers are infected; however, if your podiatrist diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.

To keep an ulcer from becoming infected, it is important to:

• keep blood glucose levels under tight control;
• keep the ulcer clean and bandaged;
• cleanse the wound daily, using a wound dressing or bandage; and
• avoid walking barefoot.

For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.”  You may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches.  These devices will reduce the pressure and irritation to the area with the ulcer and help to speed the healing process.

The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. The use of full-strength betadine, hydrogen peroxide, whirlpools, and soaking are not recommended, as these practices could lead to further complications.

Appropriate wound management includes the use of dressings and topically-applied medications. Products range from normal saline to growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.

For a wound to heal, there must be adequate circulation to the ulcerated area. Your podiatrist can determine circulation levels with noninvasive tests. 

Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. Working closely with a medical doctor or endocrinologist to control blood glucose will enhance healing and reduce the risk of complications.

Surgical Options: A majority of non-infected foot ulcers are treated without surgery; however, if this treatment method fails, surgical management may be appropriate. Examples of surgical care to remove pressure on the affected area include shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony “bumps.”

Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound. Healing may occur within weeks or require several months.

Prevention

The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis. Your podiatrist can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.

You are at high risk if you have or do the following:

• Neuropathy
• Poor circulation
• A foot deformity (e.g., bunion, hammer toe)
• Wear inappropriate shoes
• Uncontrolled blood sugar
• History of a previous foot ulceration

Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose, are important in prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. Your podiatrist can provide guidance in selecting the proper shoes.

Learning how to check your feet is crucial so that you can find a potential problem as early as possible. Inspect your feet every day—especially the sole and between the toes—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health-care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your podiatrist as soon as possible; no matter how simple they may seem to you. 

The key to successful wound healing is regular podiatric medical care to ensure the following “gold standard” of care:

• Lowering blood sugar
• Appropriate debridement of wounds
• Treating any infection
• Reducing friction and pressure
• Restoring adequate blood flow

Additional information is available from the American Diabetes Association.

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