Diabetic Foot Ulcers

It is estimated that up to 25% of all diabetics will develop a diabetic foot ulcer and about 12-24% of these patients eventually will undergo lower extremity amputations as a result of infection or gangrene secondary to unhealed foot ulcers. Unfortunately, the 5-year survival rate after one major lower extremity amputation is only about 50%. Once amputation occurs, 50% of patients will develop an ulcer in the other limb within 5 years.

A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot. Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor blood circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes as the underlying disease. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling in the feet due to nerve damage caused by elevated blood glucose levels over time. Vascular disease can complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk of infection. Elevation in blood glucose levels can reduce the body’s ability to fight off a potential infection and also retard healing.

The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance the ulcer will get infected.

Here are the key factors in the appropriate treatment of a diabetic foot ulcer:

• Prevention of infection
• Taking the pressure off the area (off-loading)
• Removing dead skin and tissue (debridement)
• Applying medication or dressings to the ulcer
• Managing blood glucose and other health problems

Over the past 2 decades significant progress has been made in the development of a wide variety of advanced wound care modalities in managing acute and chronic wounds. However, complete healing of diabetic foot ulcers remains a challenge due to many factors such as:

• Prolonged inflammation that stalls wound healing
• Excessive wound drainage and formation of bacterial biofilms that are resistant to antibiotic treatment
• Poor blood circulation (ischemia)
• Poorly controlled blood glucose level (hyperglycemia)
• Weakened barrier function (due to aging or use of steroids) rendering the skin susceptible to tears and the subsequent development of infection
• Constant weight bearing over abnormal bony prominences and/or pressure points

To address these complex issues of wound healing, one may take a "cocktail" approach and consider using a multi-functional botanical therapy that combines:

• Botanicals with broad-spectrum anti-microbial properties to protect wound bed from infection and to inhibit growth of microorganisms without harming delicate regenerating tissue;
• Naturally anti-inflammatory and analgesic botanicals to suppress prolonged inflammation and pain;
• Botanicals that promote microcirculation of the low extremities to allow fast drainage and tissue regeneration;
• Formulation that is able to absorb wound fluid (exudate) and also maintain a physiologically moist wound healing environment without causing maceration
• Formulation that allows painless and less frequent dressing change; and
• Formulation that can heal wound fast and effectively with maximum restoration of skin function and minimal scarring.