How Can An Advanced Biological Dressing Heal A Diabetic Foot Ulcer?

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One of the most dangerous situations that a diabetic can face is the formation of a diabetic foot ulcer. An ulcer is a disruption of the skin and occurs beneath the foot in an area of high pressure. The pressure may cause thick skin to form. Because of the unrelenting pressure coupled with the diminished healing ability caused by diabetes, the skin breaks down and an ulcer forms.

Someone who is not diabetic will experience pain long before the skin breaks down and an ulcer forms. Diabetes causes peripheral neuropathy, a numbing of the nerves in the feet. The diabetic peripheral neuropathy prevents the pain signals from being processed and therefore no warning is perceived before the diabetic foot ulcer forms. Adding insult to injury, people with diabetes have a reduced immune system and a foot ulcer is more likely to become infected. This puts the entire limb at risk, since infection can spread to the bone and travel up the leg.

For these reasons, it is vital to identify and get a diabetic foot ulcer to heal as quickly as possible. Every diabetic patient should have a relationship with a Houston podiatrist before a problem occurs. Your podiatrist will consider a diabetic foot ulcer to be a medical emergency. The sooner a diabetic foot ulcer is identified and treated, the better chance it can be healed quickly and without complication.

There are a number of resources that a podiatrist will use to manage and heal a diabetic foot ulcer. There are a large number of gels, foams, and other healing dressings that are the first line of attack. This is used in combination with some modality to reduce or eliminate the pressure that caused the ulcer in the first place. The benchmark that is now used, based on the 2010 Consensus Study, is a 50% reduction of wound size within four weeks. If there is less than that, we must turn to an advanced biological dressing.

An advanced biological dressing is a dermal substitute, not a skin graft, which is derived from human tissue. The dressing contains fibroblasts, which are responsible for healing wounds, within a matrix that fills in the wounds. The advance biological dressing, which includes Dermagraft and Apligraf, are applied in the podiatrist’s office and covered with a dressing that is left intact. Different protocols are used, but the dressing is reapplied every week or two until the wound is healed or until healing progress stops.

In the past, advanced biological dressings were used as treatments of last resort. That has changed. They are recognized to significantly accelerate healing of a diabetic foot ulcer. They are covered by Medicare, Medicaid, and private health insurance. If it is not suggested by your podiatrist during treatment for a diabetic foot ulcer, be sure to ask or find another practitioner who uses these advanced dressings.

85% of lower limb amputations are preceded by a diabetic foot ulcer. 15% of a diabetic foot ulcers lead to an amputation. Half of all diabetic foot ulcers that remain unhealed lead to the death of the patient within five years. Do not become part of these statistics. When it comes to a diabetic foot ulcer, “almost healed” is not good enough. Visit your podiatrist and see what more can be done to heal your diabetic foot ulcer.
Dr. Andrew Schneider
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Dr. Andrew Schneider is a podiatrist and foot surgeon at Tanglewood Foot Specialists in Houston, TX.