Global Congress on Sepsis & Wound Care [SWC 2025]

Diabetic Foot Ulcers (DFUs)
A diabetic foot ulcer is a common complication of diabetes, characterized by an open sore or wound, typically located on the bottom of the foot. It affects around 15% of people with diabetes at some point in their lifetime. If not properly treated, it can lead to serious complications, including infection and, in severe cases, amputation.

Causes and Risk Factors
Peripheral Neuropathy: Nerve damage in the feet due to prolonged high blood sugar, leading to loss of sensation. This can cause unnoticed injuries.
Poor Circulation (Peripheral Arterial Disease): Reduced blood flow to the feet can impair healing and increase the risk of ulcers.
Foot Deformities: Structural foot changes such as hammer toes or Charcot foot (weakening of bones) can increase pressure in certain areas.
High Blood Sugar Levels: Poorly controlled diabetes impairs wound healing.
Infection: Diabetics are more prone to infections, and ulcers are more likely to become infected.
Signs and Symptoms
Open sores on the foot, usually on the bottom or pressure points
Swelling, redness, and warmth around the ulcer
Pus or discharge from the wound
Foul odor from the ulcer
Black tissue (eschar) around the ulcer, indicating necrosis or dead tissue
Pain may or may not be present due to neuropathy
Stages of a Diabetic Foot Ulcer (Wagner Classification)
Stage 0: No open sores but high-risk foot deformities.
Stage 1: Superficial ulcer without infection.
Stage 2: Deeper ulcer reaching tendon, bone, or joints.
Stage 3: Deep ulcer with infection, possibly osteomyelitis (bone infection).
Stage 4: Partial gangrene (tissue death) of the foot.
Stage 5: Full gangrene of the foot requiring amputation.
Treatment
Wound Care: Cleaning and dressing the ulcer regularly, with special dressings that promote healing.
Offloading: Reducing pressure on the ulcer through specialized shoes, orthotics, or total contact casting.
Debridement: Removing dead or infected tissue from the ulcer to promote healing.
Infection Control: Antibiotics for any infection and proper cleaning of the wound.
Blood Sugar Control: Managing blood glucose levels tightly to facilitate healing.
Surgery: In severe cases, surgical intervention may be required, including debridement or amputation.
Prevention
Daily Foot Care: Regular inspection of feet for cuts, sores, or signs of infection.
Proper Footwear: Wearing well-fitted shoes to prevent pressure points and blisters.
Blood Sugar Management: Keeping diabetes under control reduces the risk of complications.
Regular Doctor Visits: Routine checkups with a healthcare provider to monitor foot health.
Smoking Cessation: Smoking reduces blood flow, exacerbating circulation problems.
Advanced Treatment Options
Hyperbaric Oxygen Therapy (HBOT): Increases oxygen supply to the ulcer site, promoting healing.
Skin Grafts: Applying artificial or biological skin grafts to large ulcers.
Growth Factor Therapy: Use of growth factors to accelerate wound healing.
Proper management of diabetic foot ulcers is crucial to avoid serious complications, including amputation. Early diagnosis and aggressive treatment are key to better outcomes.