June is Awareness Month

With June being Wound Healing Awareness Month, it is the perfect time to be mindful and proactive in dealing with what may seem like a small wound issue before it becomes unnecessarily problematic.

The Rising Epidemic

Diabetes is a global epidemic, with the number of people newly diagnosed and those “at-risk” continuing to rise.

In Louisiana alone, approximately half a million people have diabetes, and almost 40% of the adult population are “prediabetic.” According to the Center for Disease Control’s National Diabetes Fact Sheet, the state of Louisiana ranks ninth for the highest percentage of adults diagnosed with diabetes.

Diabetes causes many complications, including an increased risk of cardiovascular disease, kidney disease, blindness and a loss of sensation in the feet called peripheral sensory neuropathy.

Diabetic Foot Ulcers

Our feet are important parts of our bodies. Not only do they help us to walk, run and play, but also to feel soft sand, rocky roads or wet grass. People with diabetes may lose this ability and instead feel burning, tingling or numbness in their feet.

Peripheral sensory neuropathy affects up to 30% of people with diabetes: This creates a higher risk for falls, burns and wounds on their feet called diabetic foot ulcers. People with sensory neuropathy may not be able to feel objects in their shoe, if they step on an object or if their shoe is rubbing a blister or wound on their foot. Often, people with diabetes are unaware they even have an open wound on their foot.

Other risk factors for developing a diabetic foot ulcer are a history of smoking, poor glycemic (sugar) control and having a previous diabetic foot ulcer. African-Americans,

Hispanics, Native Americans, and older men are also at high risk for developing a diabetic foot ulcer.

People with diabetes are also two to eight times more likely to develop peripheral arterial disease. This can cause poor circulation in the hands and feet, making it harder to heal a wound.

Unfortunately, some diabetic foot ulcers become infected and are unable to heal, leading to a lower leg amputation. Eighty-five percent of all amputations in people with diabetes started as a foot wound that became infected or severely gangrenous. People with diabetes are 10 times more likely to have a lower leg amputation than a non-diabetic person.

What You Can Do

• Regular checkups. Your primary care provider and endocrinologist can help manage your blood sugar to help control your diabetes and prevent complications.

• Know your numbers. If you have diabetes, know what your A1C number is: This is a test that measures how controlled your blood sugar is. The American Diabetes Association recommends people with diabetes A1C be below 7%.

• Check your feet. Remove your shoes and socks to examine your feet daily, including the soles of your feet. Look for calluses, areas of redness, warmth or open wounds. If you cannot see the bottom of your feet, use a mirror,or get someone to help you. If you have or are at risk for diabetes, ask your health-care provider to perform a yearly foot exam. Early identification of problem areas is key to preventing wounds.

• Proper shoe wear. Do not walk barefoot if you have tingling or loss of sensation in your feet. You might not feel a small cut or scrape that can easily become infected. Wearing white socks is a way to see if you have a wound on your foot. Wear a supportive shoe with a wide toe box.

• Nail care. Have your toenails trimmed by a wound specialist or podiatrist. People with diabetes can have thickened or fungal nails making trimming them difficult. Keeping nails trimmed can prevent them from becoming ingrown or causing a wound and allows for better-fitting shoes.

• Remove corns and callouses. Walking on hard corns and calluses can cause damage to tissue and lead to an open wound. Have these cut and flattened by a professional.

Wound Care

If you notice an open wound on your foot, contact your health provider. They may refer you to a podiatrist or wound specialist. They will assess your wound and can provide a comprehensive treatment plan that may include topical dressings, debridement or removing unhealthy tissue, and offloading to relieve pressure over the wound. Casting your foot may be necessary to heal the wound.

LSU Health Shreveport’s Rehabilitation Clinic provides comprehensive wound management in an outpatient setting for people with diabetic foot ulcers as well as other wound etiologies. They also run the country’s first and only post-graduate Wound Management Residency within the School of Allied Health Professionals. A variety of topical treatments, total contact casting of the foot, as well as modalities such as ultrasound, electrical stimulation, ultraviolet light therapy and compression, are utilized at LSU Health to treat and heal wounds.

To learn more about the services offered at the Rehabilitation Clinic at LSU Health Shreveport School of Allied Health Professions, please call 318-813-2970 or visit https://www.lsuhs.edu/our-schools/school-ofallied-health-professions/rehabilitation-clinic/rehabilitation-clinic.

Sarah Murnane, PT, DPT, CWS, is the clinical assistant professor of physical therapy, Wound Management Residency Director, and Certified Wound Specialist (CWS) at the School of Allied Health Professions LSU Health Shreveport.