Top Causes of Lower Extremity Wounds

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

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 physician can test feet for neuropathy with a simple, painless tool called a monofilament. 

Vascular disease can complicate a foot ulcer further by 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. 

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. 

If you are at high risk of developing a foot ulcer, contact the wound specialists at Village Podiatry to learn how we can help prevent and treat foot wounds and ulcers.