Here’s What You Should Know About Diabetes and Slow-Healing Wounds

No bruises are minor for a diabetic.

By Laurie Yarnell 

One summer day a few years ago, Saugerties resident Kathy Mellert, 64, set off for a bike ride. “I hadn’t been on a bike for a while, and I fell; my left shin hit the pedal.” When her bruise became radically inflamed and very painful with a large hematoma, Mellert, a retired RN diagnosed with Type 1 diabetes when she was 8 years old, knew she needed immediate medical attention.

After consulting her primary care physician, she was referred to the Wound Healing Center at HealthAlliance Hospital: Broadway Campus in Kingston, a member of Westchester Medical Center Health Network (WMCHealth), where she saw infectious-disease specialist Charles Kutler, MD, the Center’s Medical Director. “I was really impressed by the up-to-date treatment and attentive care I received there,” Mellert says.

Upon examining her leg, Dr. Kutler told her he needed to open up her wound, performing a drainage procedure to release pressure built up under the skin. Mellert’s wound healed successfully, following several months under Dr. Kutler’s care and a treatment plan that included wound evaluation, vacuum and advanced-care dressings, compression, bioengineered grafts and antibiotics.

A year later, Mellert slipped on some rocks while walking into the ocean in Maine, causing her to sustain an even more serious wound. She again sought immediate medical attention from Dr. Kutler. This second wound also healed successfully.

“Diabetes is one of the major contributors to chronic wound-healing problems,” says Dr. Kutler. “When diabetic patients develop an ulcer, they become a high risk for major complications.”

November is National Diabetes Month, which calls attention to the growing effects of diabetes, a group of diseases that impair the body’s ability to produce or respond to the hormone insulin. Studies suggest that by 2030, more than 550 million individuals worldwide will suffer from diabetes. Of these, about 25 percent, like Mellert, will develop foot ulcers and leg bruises that are slow to heal and frequently require advanced wound treatment.

If left untreated, such wounds, says Dr. Kutler, can lead to infection, loss of function, amputation, sepsis (a lifethreatening condition in which the body’s response to an infection causes injury to its own tissues and organs) and even death. Fortunately, he adds, there are several things diabetic patients can do to prevent or reduce the risk of wounds that won’t heal (see graphic above).

Dr. Kutler has some important advice for anyone who is afflicted with this disease. “All diabetic wounds are of serious concern, and even minor injuries can result in serious infections.” Thus, patients who experience certain symptoms (see graphic at right) are urged to seek prompt medical attention. Because Mellert was so quick to seek treatment for both of her recent wounds, today she is doing well and back to enjoying her favorite pastimes.

WHEN TO SEEK MEDICAL CARE FOR A WOUND

Diabetics experiencing any of the following symptoms should see a doctor within 72 hours, says Dr. Kutler:

• Trauma to the feet or legs, no matter how minor. Even a small blister, wound, ulcer or new areas of warmth, redness or swelling may become a more serious problem.
• Persistent, mild-to-moderate pain in the feet or legs.
• Pain, redness or swelling around a toenail. Ingrown toenails are a leading cause of diabetic foot infections and amputations.
• New or constant numbness in the feet or legs may signal diabetic nerve damage (neuropathy) or impaired leg circulation.
• Difficulty walking. Diabetic arthritis often signals abnormal strain or pressure on the foot or an inability to perceive pain.
• Constant itching in the feet, fungal infection or dry skin.
• Calluses or corns should be professionally removed.
• Fever or a temperature of more than 98.6°F (37°C).

HOW TO PROMOTE WOUND HEALING

What measures can diabetics take to improve or promote wound healing? Dr. Charles Kutler advises the following:

• To improve circulation and overall health, stop smoking
• Watch for signs of infection. Seek medical attention if you develop any areas of concern.
• Keep pressure off wounds to aid healing.
• Control your blood sugar level and eat a healthy diet. Essential vitamins and nutrients, including adequate protein, carbohydrates and vitamin C, enhance the healing process. Consult with a registered dietician who specializes in diabetes.
• Know your body. Regularly check for open wounds or pressure points that could develop into a wound.
• Maintain good cardiovascular health and circulation. Regular aerobic exercise helps reduce chronic inflammation, a common symptom of diabetes, lowers the blood sugar and helps with weight management.

WOUND CARE AT WMCHEALTH

HealthAlliance Hospital: Broadway Campus 845.334.4325

Good Samaritan Hospital 866.596.8456

Westchester Medical Center 914.493.1500

MidHudson Regional Hospital 845.431.8144

Featured Image By Michael Polito