5 Steps to Preventing Diabetic Foot Ulcers

So, what’s the deal with diabetic foot ulcers (DFUs)? They sound so technical, but getting one can be as simple as wearing loose socks that caused your shoe to rub in just the wrong spot, or forgetting to put lotion on your heels and they begin to crack. We’ve all experienced these discomforts before, but for those with diabetes, there could be severe consequences associated with these minor nicks and blisters.

DFUs are among the most common reasons diabetic patients in long-term care are hospitalized. In fact, around 25% of patients with diabetes will develop a foot ulcer during their lifetime. These are scary numbers to the 11.2 million Americans over the age of 65 live with diabetes each year.

Due to poor blood circulation in the lower extremities, many people with diabetes are vulnerable to foot ulcerations, which can lead to severe complications. In addition to the pain that they cause, it costs on average between $8,000 and $17,000 to heal just one DFU, depending on the severity of the infection. In addition, more than 80,000 lower extremity amputations are performed each year on diabetic patients, at an average cost of $45,000 apiece.

Medline’s senior vice president of clinical services, Margaret Falconio-West recently providedMcKnight’s Long-Term Care News with insights regarding foot ulcer treatment options in this article. “In long-term care environments where residents are typically older, have limited mobility and activity levels, and have issues testing their glucose levels and adjusting insulin, the management of diabetes can be challenging. Nursing staff must be their advocates.”

While prevention and early intervention is critical, especially in long-term care, there are many treatment options for DFUs. By first looking at the wound and properly assessing it, one can then use the following is the 5-Step D.I.M.E.S. process to help prevent and treat DFUs:

  1. Debridement – Perform adequate and repeated debridement to remove necrotic tissue. Autolytic debridement can be achieved with the use of dressings in contact with the necrotic tissue that maintain a moist wound environment.
  2. Infection and inflammation – Appropriate use of antimicrobials, such as controlled released silver dressings, can make a world of difference in a person that has a DFU. There are many antimicrobial products available, and no one product is going to be right for all patients.
  3. Moisture balance – Address the actual edge and environment of the wound bed. Achieving moisture balance is a delicate act. Cells and the various cellular signals all need the right amount of moisture to move across the wound bed.
  4. Edge Environment – If the wound edge is not migrating after appropriate wound bed preparation and healing is stalled, then advanced therapies should be considered. Collagen products that act as a sacrificial dressing and allow the wound to heal itself are valuable during this time with a diabetic foot wound.
  5. Supportive products – Education and products that support those that are caring for a diabetic person with a wound.

Margaret believes that educating staff and residents is another key step to preventing DFU. “The bottom line is that prevention of diabetic foot ulcers is paramount,” says Falconio-West. “Education must include basics about the disease, warning signs and symptoms, resultant complications, and obviously prevention of the disease as well as the complications.”

Medline offers many courses online that can help healthcare workers perform at their very best. For example, Medline University created these two courses pertaining to diabetes, Understanding Diabetes for Nurses and Understanding Diabetes for Healthcare Assistants.


By Margaret Falconio-West