Your first port of call may be your Primary Care Physician or your Endocrinologist. They will need to review your general medical condition and then specifically diagnose and characterise the foot ulcer. This may turn out to be infective in which case they will enlist the help of the Microbiology Department.

Antibiotics may be the chosen treatment but the real hard work starts here, the battle is now on to achieve adequate wound healing. This will not happen if there is dead unviable tissue in the wound. You may need an Orthopaedic Surgeon to explore and clean the wound. You will definitely need the vascular supply to the leg investigated. Radiology will be required to review the bone structure, the soft tissues and the vascular supply to the leg. Intervention to open blocked arteries by a Vascular Surgeon may prove necessary.

The collaboration with a Podiatrist is essential. This will turn out to be a long road ahead. Multiple visits may be necessary to assess healing and general foot structure. One of the keys to this process is off loading the foot and preventing pressure damage. Offloading means designing a boot or cast which shifts pressure away from the affected area. A cast may have to be worn in the shorter term to aid healing, special shoes may have to be fitted in the longer term in order to prevent recurrences.

With all that going on it is easy to forget the Wound Care Team. They will have already been busy at work, collecting the microbiology specimen results, applying adequate dressings for optimum healing and collaborating with the other members of the team on whether or when to change tack from ?standard wound care? to a more aggressive approach using modern ?wound care technology?.

You may have found this introduction bewildering. It is not intended to baffle you with science, healing your foot ulcer has to be taken seriously from the outset. Concerns about losing a toe or amputating the leg is very real, it happens to someone in the world every 15 seconds.

The medical profession has made tremendous advances in this area over the past few years, we now know that in a large number of cases we can salvage what looks like a pretty dire problem. The key is teamwork and an essential element of this will frequently introduce you to the Nurses. In particular the Diabetes Specialist Nurses may be more able than most to dedicate some of their expertise and provide you with the continuity required within such a multidisciplinary area of medicine.

Optimum nutrition is a must for optimal wound healing. The balance in energy and especially of protein intake will be carefully monitored. An expert in Nutrition will be a very important part of the team.

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