Diabetic Wound Care: Prevention and Healing Expectations

     Peripheral artery disease in the legs is a silent threat that often endangers the lives of diabetic patients. The main cause is fat deposits on arterial walls, leading to vascular inflammation, fibrosis, and calcium accumulation that cause arterial stenosis or occlusion. This results in inadequate blood supply to the legs.

Consequently, when patients develop a diabetic wound, they often feel no pain. The wound becomes hard to heal, eventually turning into black gangrenous tissue on the foot. 

Treatment Methods for Diabetic Foot

     Surgical debridement of necrotic tissue or toe amputation alone usually fails to heal the wound completely and often causes it to spread further. Currently, treating diabetic foot wounds caused by arterial occlusion can be safely achieved through several methods. For patients with mild occlusion, oral medication may be sufficient.

When the Condition Becomes Severe

     Doctors may consider balloon angioplasty / catheterization or vascular Bypass surgery to restore blood flow to the leg. This can be performed even when patients have extensive arterial blockages over long segments. These reliable and advanced medical technologies restore normal blood circulation without requiring major amputation or loss of limbs.

How to Care for Feet to Prevent Diabetic Wounds

Diabetic patients should be cautious and pay special attention to foot care to prevent limb loss by following these simple steps:

• Regularly wash feet and between toes with soap and clean water, and dry thoroughly every time.
• Choose properly fitted shoes, purchasing them in the afternoon when feet are fully expanded.
• Trim toenails straight across; avoid cutting them too short or leaving them too long, and take care to prevent injuries while trimming.
• Always wear socks to maintain foot moisture and prevent friction.
• If skin is dry, apply a thin layer of moisturizer to the foot area, avoiding spaces between toes to prevent excess moisture buildup.
• Inspect feet daily, paying close attention to the spaces between toes.
• Check inside shoes before putting them on to ensure there are no foreign objects.
• Schedule regular foot examinations with a specialist doctor.
• If a wound occurs, immediately perform basic first aid and consult a doctor promptly.

Adjust Dietary Habits to Manage 'Diabetic Wounds'

     Although diabetic patients can eat most general foods, paying careful attention to food selection and portion control is vital to significantly enhancing their quality of life.

1.  Vegetables Group

     Focus on high-fiber green leafy vegetables that are low in starch and sugar. These help delay and block the absorption of sugar and fat, such as morning glory, kale, cabbage, bitter melon, and legumes.

2.  Fruits Group

     Choose low-sugar, high-fiber fruits such as guava, papaya, apples, tangerines, pomelo, and rose apples, with a recommended portion of 3-4 servings per day.

3.  Dairy Group

     Drink plain milk, low-fat milk, skim milk, or unsweetened soy milk. Limit consumption to no more than 1-2 glasses/day (250 cc per glass).

4.  Rice, Starch, and Grains Group

     Select minimally processed carbohydrates like brown rice, whole grains, and whole wheat bread, limited to 8-9 ladles/day. Avoid desserts and use caution with artificial sweeteners, as they may increase sugar cravings.

5.  Meat Group

     Focus on fish, lean meat, and skinless poultry, limited to no more than 12 tablespoons/day. Patients without high blood cholesterol can eat up to 2-3 eggs daily.

6.  Fats Group

     Choose foods prepared with healthy fats such as rice bran oil, soybean oil, or corn oil, limiting consumption to 6-7 teaspoons/day.

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How to Care for 'Diabetic Wounds' to Avoid Amputation

In addition to controlling blood sugar levels within normal limits, diabetic patients should avoid injuries. If a wound occurs, diligently practice and monitor self-care according to the following recommendations:

• Maintain cleanliness
• Clean wounds regularly: 2-4 times daily with soap and warm water or normal saline, drying thoroughly each time. Avoid rubbing alcohol, as it destroys tissue proteins and delays healing.
• Keep the wound dry and covered: After cleaning and thoroughly drying, apply prescribed antiseptic ointments strictly, keep the wound completely covered, and avoid any contact with water.
• Monitor closely for signs of infection: If abnormalities occur—such as increased pain, swelling, discharge, or pus—seek immediate medical treatment to prevent severe systemic infection.
• Prevent pressure ulcers: To prevent tissue necrosis and secondary infection, reposition every 2 hours to avoid sustained pressure on wounds. Clean with antiseptic solutions or normal saline and cover with sterile dressings.