How To Manage Foot Ulcer

 

Basic guidelines to follow when dressing your foot ulcer

STEP 1: Wash your hands thoroughly before you apply the dressing.

STEP 2: Cleanse the ulcer with saline (salt water). 

Once the dressing has been removed, wash the ulcer with normal saline which is available from the chemist. It is important that the foot is not “bathed” as this can increase the risk of infection. You can make a salt solution at home by dissolving a teaspoon of table salt in hot water in a mug and diluting it with cold water until the mug is full.

STEP 3: Dry the ulcer before dressing

Do not place the dressing on the ulcer if moisture is still present. Dry with a clean towel.

STEP 4: Apply the appropriate dressing

The podiatrist has specifically chosen the dressings for your foot ulcer that will be most beneficial for you. These may change over time during the course of your treatment.

STEP 5: Secure dressing properly. 

A foot ulcer dressing needs to stay in place and your podiatrist may recommend tape or bandages to do this. Too much tape is not good for your skin and your podiatrist will often avoid using it if possible,

 

 

General Principles

  • Do not leave the foot ulcer uncovered for any period of time

Once the ulcer has been cleansed it is essential that it be dressed immediately. Do not remove the dressing before your podiatry appointment unless advised.

 

  • Keep ulcer dry

It is very important that the ulcer and dressing do not get wet in the shower or bath as this can increase the risk of infection. You can try to use a plastic bag to keep the foot dry however, we recommend you also use a shower chair to reduce seepage of water into the bag and to prevent slipping. If the dressing does get wet, you should change the dressing as soon as possible.

 

  • Dressing changes

Only change the ulcer dressing as often as directed. If you change a dressing too often you can disturb the wound and slow down the healing. If you do not change the dressing often enough, you can risk developing an infection.

 

  • Continue to dress the ulcer

Sometimes the ulcer may look like it has healed when it hasn’t. It is important to dress the area until further advice from your podiatrist or doctor.

 

  • Use prescribed offloading devices and equipment as recommended

Ulcer dressings typically work more effectively in combination with other treatments that take pressure off the ulcer. These include orthotic, post operative healing shoes, orthopaedic footwear, offloading walkers and crutches.

 

In general, it is recommended when you have a plantar foot ulcer that you rest the feet as much as practically possible, by keeping weight-bearing activities to an absolute minimum.

 

 

Monitoring for infection

One of the complications of foot ulcers is the risk of the wound becoming infected, which can lead to serious consequences. It is important that the ulcer and foot be thoroughly inspected by yourself or a family member/friend at every dressing change.

 

Symptoms that may indicate an infection include:

  • increased redness or swelling around the ulcer or foot

  • pain from the ulcer, or the foot and leg in general

  • ulcer dramatically changes colour

  • fluid from the ulcer starts to become “pus-like”, heavier or develops a foul odour

  • fevers and chills, or generally feeling unwell

  • if you are diabetic, your blood sugar levels may go higher and/or be erratic

 

Should you experience one of a number of these symptoms, then an infection may be present, it is important to seek immediate medical help.

 

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