Wound Care for Diabetics

According to the CDC, the risk of death for adults with diabetes is 50-percent higher than adults without the disease, in part because it affects the whole body and can lead to hardening of the arteries. Ongoing, elevated blood sugar levels damage blood vessels, which directly affects the manner by which a wound is perceived, and subsequently healed.

Over time, these uncontrolled blood sugars can cause significant nerve damage or peripheral neuropathy, especially in extremities like hands and feet. This nerve damage can manifest as weakness, pain or numbness, which means a wound can occur and worsen without the patient’s knowledge!

Monique L. Abner, M.D., CWSP, medical director of the Meritus Wound Center, said, “Patients need a raised level of awareness when they receive the diabetes diagnosis.”

New wound treatments

Total contact casting or TCC is a modern, advanced treatment Dr. Abner often recommends for her diabetic patients. This is one of the most significant medical interventions that can benefit a diabetic neuropathic ulcer, since it offloads pressure from the foot, allowing it to fully heal.

Offloading with TCC, coupled with podiatric intervention, is essential for immediate treatment and important for the prevention of recurrent ulcers.

Dr. Abner also uses negative pressure wound therapy. This augments healing by subjecting the wound to a vacuum dressing that stimulates the growth of more blood vessels.

“Our office has disposable wound VACs or vacuum-assisted closure devices that last about a week, run on batteries and look like an advanced bandage,” said Dr. Abner.

Other advanced technologies for wound treatment include cellular tissue product applications and hyperbaric oxygen therapy. Hyperbaric oxygen therapy may help a patient’s body heal faster by increasing the amount of oxygen in the body. The patient is placed in a chamber and subjected to a 100-percent oxygen environment for multiple two-hour sessions.

Prioritize foot care

Dr. Abner recommends diabetic patients pay extra attention to their feet.

“When we see a new patient, we address a complete review, including the needs of vascular assessment, infection control, podiatric evaluation and overall wellness - an eye exam, kidney assessment and glucose control,” said Dr. Abner.

She recommends a podiatrist to provide foot care and prevent wounds.

“A podiatrist can do a gait analysis to see what kind of orthotic can be created to offload pressure from an existing wound,” said Dr. Abner.

Prevention is the best treatment

Whenever possible, prevention is best. For those living with diabetes, this means maintaining steady blood sugar levels, eating right and practicing mindful foot care.

“If you don’t want to end up in a vicious cycle, protect your feet, inspect them and don’t do your own foot care,” recommends Dr. Abner. “Go to a podiatrist and if you get a wound, come to the Meritus Wound Center.”

Meritus Health, at 11116 Medical Campus Road, east of Hagerstown, is the largest health system in the area, providing hospital and outpatient services to the community. Subscribe to Your Health Matters, a monthly e-newsletter with important health information, at