Chronic Diabetic Wounds or Diabetic Foot Ulcer (DFU) is a wound condition occurring on the feet or legs of diabetic patients that does not heal within the normal time frame (more than 4 weeks). The main cause is continuous high blood sugar levels, leading to abnormalities in blood vessels and nerves, resulting in reduced blood circulation, numbness in sensory nerves, and impaired immune system function. This causes slow wound healing and easy infection.
Diabetic wounds are one of the major causes of foot and leg amputations in diabetic patients worldwide. Data from the World Health Organization (WHO) indicates that 15-25% of diabetic patients have a chance of developing foot ulcers at least once in their lifetime, and if not properly treated from the early stage, the wound may become severely infected leading to limb loss.
For this reason, proper care and treatment of diabetic wounds from the beginning is crucial. At Phyathai Hospital 2, we have a team of specialized doctors and multidisciplinary professionals with extensive experience in managing chronic diabetic wounds, using modern and internationally standardized treatment techniques to help wounds heal faster, reduce the risk of complications, and maintain the best quality of life for patients.
Why do diabetic patients easily develop chronic wounds?
- Peripheral artery narrowing or blockage (Peripheral Artery Disease) causes insufficient blood and oxygen supply to the feet, resulting in slow tissue repair.
- Nerve degeneration (Peripheral Neuropathy) patients often do not feel pain or temperature changes, so they do not notice minor wounds or injuries.
- Reduced immune function High blood sugar interferes with white blood cell function, slowing the body’s ability to fight infections.
- Complicated infections Open wounds and dry, cracked skin make it easier for pathogens to enter the body.
- Impaired wound healing (Impaired Wound Healing) High sugar levels affect collagen and new tissue formation, causing delayed wound closure.
Comprehensive principles for chronic diabetic wound care
Treating diabetic wounds is not just about wound care but also managing all related factors to promote faster healing and reduce recurrence. We use a holistic care approach (Holistic Care) in collaboration between endocrinologists, surgeons, wound care teams, specialized nurses, and physical therapists to provide comprehensive care covering both wound treatment and associated factors as follows:
- Blood sugar control Adjust dietary habits by reducing high sugar and simple carbohydrate intake, exercise regularly as advised by the doctor, use medications or insulin according to the treatment plan, and regularly monitor blood sugar levels.
- Proper wound cleaning and care Clean wounds with sterile saline (Normal Saline) and avoid using tissue-damaging agents such as iodine tincture or alcohol on open wounds. Cover wounds with appropriate dressings (e.g., Hydrofiber, Hydrocolloid) to maintain moisture (Moist Wound Healing) which helps wounds heal faster.
- Debridement helps remove dead tissue, pus, and nonviable tissue, stimulating new tissue growth. It should be performed by wound care specialists.
- Pressure off-loading (Off-loading) use assistive devices such as special shoes, insoles, or Walker Boots, and reduce walking or standing for long periods while the wound is still open.
- Use of modern technology and innovations
-
- Negative Pressure Wound Therapy (NPWT) uses negative pressure to remove waste, reduce swelling, and stimulate new blood vessel formation.
-
- Hyperbaric Oxygen Therapy (HBOT) treatment with high-pressure oxygen to increase oxygen levels in tissues and accelerate wound healing.
-
- Growth Factors and Skin Substitutes are agents that accelerate skin repair and artificial skin that stimulate tissue formation.
6. Infection prevention and control assess infection symptoms such as swelling, redness, heat, pain, or pus. Use antibiotics appropriately without overuse and continuously monitor the wound.
Prevention of diabetic wounds
- Check your feet daily by yourself and use a mirror to see areas that are hard to view.
- Wash your feet daily and dry thoroughly, especially between the toes.
- Apply lotion to moisturize the skin to reduce dryness and cracking (except between the toes).
- Choose properly fitting shoes that do not squeeze or rub.
- Avoid walking barefoot.
- Have your feet checked by a doctor at least once a year or more frequently if at high risk.
Warning signs that require immediate medical attention
- Wound does not improve within 1-2 weeks
- Wound is swollen, red, hot, or has pus
- Skin around the wound changes color to dark or purple
- Fever, chills, or fatigue
- Foul odor from the wound
Specialist medical team at Phyathai Hospital 2 ready to care
Chronic diabetic wounds require serious and continuous care. Effective treatment depends on a multidisciplinary team with experience and specialized expertise, including endocrinologists, surgeons, wound care teams, specialized nurses, and physical therapists.
The care team at Phyathai Hospital 2 is ready to provide detailed assessments and develop appropriate treatment plans to help wounds heal faster, reduce infection risks, and prevent limb loss. If you or your loved ones have diabetic wound problems, you should see a doctor for care from the early stage.
