1) Diabetes:
If you have diabetes, it is very important to optimize your blood sugars. Work with your doctor (family doctor, endocrinologist, or internal medicine) to lower your blood sugar to prevent future infections and promote healing of your wound. Poor diabetes control impairs the healing process and contributes to infection.
2) Peripheral Arterial Disease:
You may need assessment of the blood flow to your feet and legs to check if there are any blockages in your arteries that may be impairing your ability to heal. A CT scan may be necessary to obtain images of your arteries to find out where the blockages are located. You may need to see a vascular surgeon to decide if there are interventions that can correct the blood flow.
3) Venous Insufficiency:
Your veins carry blood to your heart. When they do not work properly, blood pools in your legs and causes swelling. The swelling can lead to blistering and wounds. Compression stockings or dressings are often required to reduce the swelling. They must be tight to work properly.
4) Wound Care:
You need diligent wound care to keep the area clean, prevent worsening, and promote healing. Home care nurses can provide wound care for you in the community. If you are mobile, you will need to go to a home care clinic on a regular basis to get wound care. If you are not mobile, a nurse may be able to come to your home to provide wound care. You may also need to see a wound care specialist if your case is complex.
5) Off-loading:
You need to avoid putting too much pressure on your wounds for prolonged periods of time. Wounds located on the feet, buttocks, hips, and back can be difficult to heal because these areas often experience high pressure. You may need a special cushion or mattress to reduce the pressure in these areas. If you are in bed for most of the day, you may need to be turned regularly to off-load specific areas of your body.
6) Treat the Infection:
Infections are usually a complication of a chronic wound, rather than the cause of it. Antibiotics are used to treat infections of wounds and your doctor will decide the best treatment for you. Antibiotics may be given by mouth or through an intravenous catheter. Antibiotics do not cure a wound and do not need to be continued until the wound has fully healed. To heal a wound, the underlying cause must be addressed. Sometimes, surgery may be required to remove infected tissue from a wound.
