Wound Care Management

Diabetic Foot

Wet wound with granulating tissue, yellow slough, and some black escharCauses:
  • Many foot ulcers are caused by improper foot wear or foot injury secondary to neuropathy. Patient education about proper footwear is essential for diabetic patients (patients with neuropathy often choose shoes that are too small).

Goals of treatment:

  • to heal or simply protect the wound
  • prevent infection

Things to keep in mind:

  • remove or prevent pressure on the area
  • foot care (Chiropodist)
  • blood glucose management
  • patient's actual and potential circulatory status
  • patient prognosis
  • quality of life

Suggested treatment*:

if the goal is to heal the wound...

  • the first step would be to have the hard callus removed by sharp debridement (this would be done by a physician or a wound care specialist). Once the wound base is revealed it can be properly staged.
  • If sharp debridement is not an option and the goal is still to heal this wound, then a moisture-retentive dressing (Alldress with Intrasite gel or 3M Tegasorb) would be the choice.
  • If a longer application time is possible then a foam dressing (Mepilex Border or Allevyn) could also be used with the Intrasite gel.

If significant neuropathy and evident circulatory insufficiency, debriding the wound may actually create more problems re: infection. Thus the goal is to simply protect the wound ...

  • a dry gauze and kling dressing can be applied

treatment for this wound...

  • the suggested dressing* for this non-infected wound is a Mepilex border foam dressing which can stay on for 5-7 days.
  • this dressing can be changed q7 days

* All suggested treatments and dressings in this web site were evidence based choices by the authors and by no means represent the only dressing option available.

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