Wound care is key to maintaining health for diabeticsMarch 29, 2012
Wound care is a dangerous fact of life for diabetics.
Even the most minor of cuts can lead to the loss of a limb if not treated quickly and carefully. Massive sores on a diabetic’s feet, known as foot ulcers, are among the most common and most risky wounds a person can suffer. Edith Ford has had diabetes for more than 20 years and knows all too well the hassle that comes with the disease.
“I get sores just above my ankle,” she said. “I’ve been having these for 20 years, so I pretty well know the routine.”
Each time one of the sores pops up, she and her daughter try to treat them at home. But after a month, if there’s no sign of improvement, she makes an appointment at the Center for Wound Healing at Southwestern Medical Center. Dr. Aryan Kadivar, medical director of the center, treats the wounds with a vast array of options.
“We usually address five aspects when treating the wound,” he said. “We’ll look at debridement, the infection, edema or swelling, vascular blood supply and offloading. We look at one of those, if not a combination, that we feel needs to be addressed to allow treating of the wound.”
The center also has two hyperbaric chambers that can be used to treat wounds with oxygen therapy. The chambers push oxygen into the wounds and into the blood, which allows the wounds to heal more quickly than before. Kadivar said many of the patients that walk through the doors into his facility are diabetics that suffer from wounds that simply would not heal otherwise.
“When you get down to it, their ability to heal is severely hampered by the marginalization of their white blood cells,” he said. “This all depends on how well they control their blood sugar and other factors.”
Controlling a diabetic diet is one of the most efficient ways to avoid complications later in life. To help raise awareness of the disease, which affects nearly 26 million Americans, the American Diabetes Association has designated Tuesday as American Diabetes Association Alert Day. The day is set aside to help raise awareness for symptoms, complications and treatments for diabetes.
Foot wounds are the most common issue facing diabetics. The increased tendency of foot ulcers is often due to neuropathy — a condition among diabetics where they begin to lose feeling in their feet. A person suffering from neuropathy could step on something sharp and never feel it. Kadivar said the pain receptors are deadened, and a person could go a long time without ever realizing he or she has an injury. Blood flow to the lower extremities is also a concern with diabetics , which can lead to sores forming and issues with healing.
“The curvature of a diabetic’s feet eventually begins to break down,” Kadivar said. “There’s more pressure put on the entire foot, which can also lead to sores and cuts. These wounds pop up quicker and are harder to treat if the blood sugar isn’t properly monitored and controlled.”
Kadivar suggests diabetics maintain a close observation on their feet. If caught soon, a wound can often be treated either at home or by a family physician without ever needing to be escaamputation ,” she said. “I have a lot of confidence in them out there. They always manage to do a good job for me.”
Amputations are the ultimate concern for any diabetic suffering from wounds. When a patient’s treatment is escalated to the Center for Wound Care, it’s because the wound hasn’t responded well to treatments after 30 days. Around 90 percent of the center’s patients are doctor referred. If not handled soon, amputation could be in the near future for patients. Scott Leckie, the program director for the Center for Wound Care, said 85 percent of amputations can be prevented by medical facilities like the one at Southwestern Medical Center.
“These wounds lead to complications that can cause serious issues,” he said. “Our facilities here are designed specifically to avoid that prospect and to help cure these wounds that arise.”
Between 85 and 90 percent of all wounds that come to the center are healed within 10 to 16 weeks. According to Leckie, the national average for wound healing is between 75 and 80 percent within 16 to 20 weeks. He said having a facility dedicated to wound care and healing is the reason this area’s healing averages are higher than the rest of the country.
“Everything we do here is geared toward healing these tough wounds,” he said. “Amputation is a danger that they’re all aware of. We want to avoid that for their sakes.”
“When you get a wound like that you need to go to your doctor and have them treat it quickly,” Kadivar said. “Every time a diabetic goes to the doctor for a check up, they should take off their shoes and socks and have the doctor look them over. The doctor should also check for neuropathy. When at home, family members should look at the feet and make sure there are no sores.”
Ford keeps a careful eye on her feet and ankles in the event any sores do pop up. Her daughter also helps her examine her feet to make sure nothing is developing. Over the past 10 years, Ford has had to visit the Center for Wound Care, and it’s not something she looks forward to. But she does appreciate its being there for her and people like her.
“When I go in, they do these labs to find out if there’s an infection or anything,” she said. “Then they would have to debride it, which means removing this old nasty stuff. And then they wrap it in their special stuff and give me instructions so we can take care of it at home.”
Ford has scar tissue around her lower leg and ankles dating back to the late 80s. If she doesn’t take good care of her skin, it will eventually crack and break open, forming bad sores. If not treated, Ford said she knows the alternatives.
BY JOSH ROUSE
STAFF WRITER, LAWTON CONSTITUTION