Wound Care in Diabetics

OB/GYN News,  March 15, 2000  by Sally Koch Kubetin

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Blood sugar and blood pressure are two keys to wound healing in diabetic patients with foot ulcers, panelists said during discussion held at the annual conference of the Canadian Association of Wound Care.

Maintain blood sugar levels to avoid excessive glycosylation and increased stiffness of tissue. This is one of the major factors of immobility of the diabetic foot that also delays healing of the ulcer, said Dr. Anne Kenshole of Women's College Hospital, Toronto.

Regardless of age, blood pressure should be no greater than 135/85 mm Hg. Use ACE inhibitors and [beta]-blockers Dr. Kenshole advised. Calcium channel blockers are not recommended unless the limb is ischemic; only calcium channel blockers provide peripheral vasodilatation.

Most of these patients are depressed and, thus, unmotivated to comply with treatment regimens, she said. Use antidepressants more regularly.

Information on foot care must be meaningful. Patients are advised to remove their footwear and should be shown not only how to check their feet but how to check their shoes and socks as well. Patients unable to examine or care for their own feet should seek regular professional assistance, said Heather Orsted, R.N., a clinical nurse-specialist for Calgary (Alta.) Health Services.

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