Wound care is a very complex management system.
Many people may develop lower limb and foot wounds throughout the aging process. Certain conditions and hereditary factors can contribute to the risk of developing wounds.
This may include; Autoimmune diseases, circulatory impairment, Diabetes that can affect the sensory, autonomic and motors nerves in the lower extremities causing loss of protective sensation, changes to supportive structures, and a reduction in the function of organs which aid in improving skin integrity. This can create many negative effects such as; the inability notice, when your feet are injured, changes to the shape of feet causing excessive pressure areas, and a decrease in the natural production of sweat glands that hydrated the tissues and skin causing them to become dry and more likely to crack and callous. A small skin problem such as a callus, corn, fissure and blister has the potential to turn into a larger sore, referred to as a foot ulcer. Due to the usual decrease in microvascular circulation related to excessive elevation of blood sugars in diabetics will decrease the ability for the bodies own natural antibodies to reach the affected area through blood circulation causing a potential infection to take hold. Wounds will not heal if infected. Foot ulcers form most often on the pad (ball) of the foot or the bottom of the big toe and the heel and other locations. Typically, over boney prominences and high areas of pressure. If toe deformities are present such as; hammer toes, claw toes, or bunions the potential to develop a wound is possible if not off loaded and protected.
- Addressing immediate cause of the wound
- Underlying pathology
- Local problems at the wound site
- Risk assessment to prevent further tissue breakdown
- Bacterial load
- Patient’s goals
- Exudate levels
- Granulation tissue
- Pain prevention
Adjunctive Therapies Include:
- Low level laser therapy/Phototherapy
- Wound dressings
- Off loading strategies
- Solutions for pain management
- Nutritional and fluid intake consultations
- Healthy lifestyle choices
- Referrals to other practitioners offering additional support