Recent Fox Attacks in Maine May Be Due to New Rabies Strain
How To Care For Diabetic Ulcers And Sores
Diabetes makes you more likely to have sores and ulcers. Ulcers are open sores (also referred to as wounds) on your skin that don't heal the way they should. You're most likely to get ulcers in your feet and legs, but they can also form in other areas, like your hands or in folds of skin on your stomach.
There are several reasons why diabetes raises your odds of getting ulcers. One of the main symptoms of diabetes is high blood sugar (also called blood glucose). Over time, high blood sugar levels can damage your nerves and blood vessels. That lessens blood flow (especially to your hands, feet, and limbs), which makes it harder for sores and cuts to heal. It makes you more likely to get an infection, too. What's more, diabetes is linked to a condition called peripheral arterial disease (PAD), which lessens blood flow to your legs and feet.
Nerve damage also makes it harder for you to feel pain or other symptoms of ulcers or infections. That can keep you from treating smaller wounds before they become ulcers.
Ulcers are dangerous because they can lead to serious infections or even gangrene, which is when your tissue dies. In some cases, the only way doctors can treat the infection or gangrene is to amputate the affected area.
If you do get an ulcer or notice a change in your skin that you're not sure about, tell your doctor right away. You'll likely get a procedure called debridement, which removes unhealthy tissue from the wound to spur healing.
Your doctor will also work with you to try to keep your sore or ulcer from getting infected and becoming bigger. Some of the steps they may recommend include:
Clean your ulcer daily. Use soap and water, unless your doctor recommends another cleanser. Don't use hydrogen peroxide or soak your wound in a bath or whirlpool, because this could reduce healing and may boost your odds of infection.
Keep your ulcer bandaged or covered with a wound dressing. (Your doctor may recommend specific bandaging steps depending on the location of your ulcer.) While you may have heard that it's important to "air out" wounds, experts now know that not covering a wound actually increases the odds of infection and slows healing.
Keep pressure off your ulcer, especially if it's on your foot. This may mean you need to use crutches, special footwear, a brace, or other devices. Reducing pressure and irritation helps ulcers heal faster.
Use the topical medications your doctor recommends. ("Topical" means that the medication goes on your skin.) These may be saline, growth factors, and/or skin substitutes.
Keep your blood sugar under control. In addition to reducing your risk of ulcers, tight blood sugar control helps your body heal existing ulcers.
If your wound doesn't heal in about a month or becomes an infection that spreads to the bone, you may need other treatments. These can include surgery (most often to remove pressure-causing problems, such as bunions) and hyperbolic oxygen therapy, which involves breathing pure oxygen in a special room in order to help your body heal.
If your ulcer develops gangrene and your tissue dies, your doctor may have to amputate (surgically remove) that area of your body.
There's a lot you can do to lower your chance of having ulcers in the first place:
Keep your blood sugar in check. Good blood sugar control is the single best way to prevent small cuts and sores from becoming ulcers. If you have trouble managing your blood sugar, tell your doctor. They can work with you to make changes to your medication and lifestyle that will keep your blood sugar from getting too high. Even if your blood sugar level is fairly steady, it's still important to see your doctor regularly. That's especially key if you have neuropathy, because you may not feel damage to your skin and tissue.
Check your skin every day, and pay special attention to your feet. Look for blisters, cuts, cracks, sores, redness, white spots or areas, thick calluses, discoloration, or other changes. Don't rely on pain; even feeling more warmth or cold than usual can be a sign that you have an open wound on your skin, and it's possible that you may feel nothing at all.
Ulcers are most likely to form on the ball of your foot or the bottom of your big toe, so be sure to check your feet every night. (Ask a family member to help you if you can't check on your own.) If you notice a problem, or you aren't sure if something's normal, call your doctor.
Don't smoke. Smoking damages your blood vessels, decreases blood flow, and slows healing. Those things raise your risk of ulcers and amputation.
Don't walk barefoot. Injuring your toes or foot can raise your chances of serious problems. Wearing shoes that cover your whole foot can help prevent injury. Medicare and health insurance may cover prescription shoes that lessen your risk of foot sores.
How To Recognize And Treat An Infected Cut, Burn, Or Abrasion
Some cuts, abrasions, and burns will heal quickly while others take their sweet time. The location of the injury, how deep it is, what caused it, and how you treat the wound can all cause the healing process to take more or less time than usual.
A cut might not look pretty while it heals, but that doesn't necessarily mean that anything is wrong. But there is a point where a the way an injury looks and feels can signal a problem, usually an infection. Just like an infection inside your body, you don't want to ignore infections in or on your skin.
So what's normal and what isn't when it comes to cuts? And how should you treat a cut that's become infected? Here's a guide to decoding if the wound on your skin has become infected and ways to treat it.
Sasi Ponchaisang / EyeEm/Getty Images
Identifying infected wounds can be tricky because mild redness, swelling, and pain are normal in the first hours and days after you get a cut.
Additional Symptoms"Any redness that extends more than a quarter-inch around the cut or doesn't go away can be a sign of infection," said Michael Billet, MD, an emergency medicine physician at Mercy Medical Center in Baltimore, Maryland. Dr. Billet added that "symptoms like fever, chills, swollen lymph nodes, and malaise indicate the infection is spreading outside the area of the injury."
If the affected area around your cut is growing and you're feeling physically ill in any way, those are signs that something is wrong. You may also notice that the skin around your cut is swollen and warm to the touch. It's possible you might see red streaks moving from the center of the cut outward. And there could be pus or discharge oozing from the cut as well.
AppearanceHere's an example of what an infected cut looks like; note how the redness has spread more than a quarter-inch from the opening in the skin and how some parts of the cut look puffy and crusty.
dermnetnz.OrgThere are two things that increase your risk of an infection post-injury, said Dr. Billet: the type of cut and your overall health. Cuts are more likely to become infected when the cut is:
"A relatively clean cut, like one from a just-washed kitchen knife, is less likely to cause an infection than stepping on a piece of glass at the beach," Dr. Billet explained.
But your own health history plays a role here, too. Certain medical conditions, like diabetes, obesity, athlete's foot, or eczema can cause cuts to become infected more easily.
If you have a relatively small or minor cut and no major health complications, you might be able to treat your infected cut at home, if you catch it early enough.
"Very early on in the infection, when it's mildly red, you can apply some heat to the area to increase circulation and bring your natural blood cells to the area [to promote healing]," William Edwards, MD, an emergency medicine physician at Houston Methodist, told Health.
Additionally, you should aim to follow two basic first aid steps: Clean and cover.
CleanThere are several ways to clean a cut. But generally, you can follow these steps:
You should put a clean bandage or wound dressing on your cut and change the bandage at least daily until the cut has scabbed over. Using an antibiotic cream is optional; some people find this speeds the healing process, but others may have an allergic reaction to products like Neosporin; and that reaction can actually mimic infection symptoms, said Dr. Billet.
If cleaning and covering your cut doesn't stop the early stages of infection, you'll have to see a healthcare provider for further treatment. If your cut or burn is deep, it's important to do this as soon as possible, said Dr. Edwards, because stitches typically can't be used when a cut is more than 12 hours old. He also noted that sometimes shallow cuts in certain jointed locations—like elbows or knuckles—can be sutured to avoid the constant re-opening that may happen with frequent use.
You May Need AntibioticsEven if stitches aren't required, a healthcare provider may need to debride your cut (aka, clean it of dead or infected tissue) and prescribe antibiotics to prevent infection. A variety of antibiotics are used to treat infected cuts.
"Human or animal bites require one type of antibiotic while we use another type for normal scrapes and cuts," said Dr. Edwards. "Superficial infections can be treated with oral antibiotics but deeper infections...May require inpatient IV antibiotics and maybe even surgical drainage."
Don't Ignore A Small CutEven if your cut was initially small, don't dismiss signs of infection or assume it will simply go away on its own; even tiny cuts can be a window of opportunity for pathogens, some of which can lead to serious illnesses and require immediate medical attention.
"Infection that is spreading outwards from the cut or streaking away from the cut almost always requires antibiotics," explained Dr. Billet, "and any cut that happens in dirty water should be checked out since they usually need antibiotics to prevent an infection."
If Your Symptoms Aren't ImprovingDr. Billet said pain and redness that isn't getting better after washing and using over-the-counter (OTC) pain relievers should be evaluated by a medical professional—and it's better to be safe than sorry. "Basically if you're worried, get it checked out," Dr. Billet advised. "I would rather see 100 worried well patients than have someone sit at home and have things get worse."
Some common complications of infected cuts can include:
Most of these complications are rare if you get prompt medical care, but your risk for scomplications increases the longer you leave an infection untreated.
The easiest way to prevent a cut from becoming infected is to follow the same two steps for care of an infected cut: Clean and cover.
"The easiest and most effective treatment is to hold the cut under a forceful stream of tap water for at least a minute," said Dr. Billet. "Longer if the cut is large or particularly dirty."
Dr. Edwards agreed, saying that turbulence is one of the best approaches for dislodging particles that could cause infection. After that, Dr. Edwards recommended cleaning the cut daily with a half-strength mixture of hydrogen peroxide and water, using a topical antibiotic ointment like polysporin or bacitracin, and applying a non-adherent covering over the cut loosely enough that it won't disrupt the healing process when you need to remove and change the bandage.
Treatment Of Wound Infections
Treatment of wound infectionsWound healing is impaired by the presence of infection with more than 100,000 bacteria per gram of tissue. Infection is usually recognized by the presence of purulent exudate, surrounding erythema, foul odor, tenderness, and systemic signs; the presence of these signs is an indication for antimicrobial therapy.
Wound swab cultures often reveal polymicrobial growth, making it difficult to distinguish colonization from true infection. Curettage of the ulcer base after debridement, needle aspiration, or tissue biopsy are more reliable for identifying the pathogenic organisms, but are not usually necessary unless the ulcer does not respond to topical anti-microbials. Topical antimicrobials, including gentamicin, silver sulfadiazine, and mupirocin, are effective in reducing bacterial levels and improving the appearance of infected ulcers. A two-week trial of topical antimicrobials may be considered in wounds that do not appear infected but are not clinically improving. On the other hand, topical antiseptics such as povidone-iodine, sodium hypochlorite, or hydrogen peroxide should be avoided since they may be toxic to fibroblasts. Systemic antibiotics are reserved for serious infections resulting from pressure ulcers (eg, bacteremia or osteomyelitis).Maintaining a moist wound environmentWound fluids may contain tissue growth factors that facilitate reepithelialization. Thus, pressure ulcer healing is promoted by dressings that maintain a moist wound environment while keeping the surrounding intact skin dry. A moist wound environment is promoted by loosely packing the wound with saline moistened gauze that is not allowed to dry, although occlusive dressings are equally effective and reduce the nursing time required for wound care.
Comments
Post a Comment