From our practice Ulcer
An ulcer is a wound that does not heal, or heals unusually slowly. This is a dangerous complication, but it is often the result of a very common skin injury:
- mechanical injuries (cuts, blisters, prolonged pressing in shoes, etc.),
- pressure of a thick layer of horny skin on the soft tissue beneath it,
- burns (with hot water bottle, heating pad),
- chemical damage (eg corneal emollients).
An ulcer can be very painful if the cutaneous nerves are still healthy, but it can be absolutely nothing if the nerves are destroyed. An ulcer caused mainly by poor blood circulation (ischemic ulcer) usually occurs at the edges of the foot or toes, where the tissue has been exposed to prolonged pressure (a few hours is enough). The ulcer, which occurs after the rupture of horny skin at sites of prolonged exposure to increased pressure during walking, is surrounded on the sole by a wreath of residual cornea. It is characterized by severe damage to the nerves of the foot and rarely hurts because the nerves that sense pain are destroyed.
How you can recognize the increased risk of foot ulcers in a timely manner
Nerve damage is recognized by insensitivity to touch. Touch the skin of your toes and feet with a cotton ball.
Poor blood supply is known by these signs and problems: the foot is cold, the patient often has a cold in the legs, after a certain distance during walking there is pain in the hips or thighs. The skin of the feet is cold, may be cherry-colored, the nails are thickened, the skin is dry and flaky. Ask your doctor to feel the pulse of the vein on your instep and behind your inner ankle.
Hard and horny skin is a sign of excessive pressure when walking. With a healthy foot, the skin at these points is normally thin and soft.
Act now Gangrene and amputation
Gangrene is the death of tissue. We distinguish between dry and wet gangrene. In dry gangrene, which results from interruption of blood flow, the dead tissue is hard and black. Wet gangrene is an infection that causes fluid to drain due to inflammation in living tissue.
Fallen tissue must be removed by surgery (amputation). The extent of the amputation (toe, part of the foot, foot, shin, or above the knee) depends on the extent of the collapsed tissue and the condition of the arterial circulation. The part of the limb that remains may be well perfused to allow the wound to heal well after amputation.
