Hello, it’s Dr. Bill Releford from The Releford Foot and Ankle Institute “Where Amputation is Not Always The Answer”. Today we are talking about 8 Important Wound Care Tips for Diabetics.
There was a time when a minor cut only needed a quick wash and a bandage – and a mother’s magical healing kiss if you were a youngster. But if you have diabetes, a wound, cut or skin abrasion requires much more care and monitoring.
In most people who have diabetes, wounds and cuts heal slower than in non-diabetics. Diabetes also increases the chance of an infection in minor wounds and cuts. A small cut can turn into a large and very serious complication.
For example, a small injury on the foot can lead to foot ulcers. Diabetic foot ulcers, which are painful sores that can ultimately lead to foot amputation, affect 15 percent of people with diabetes.
Yes, amputation is a real possibility in severe cases. Do not make the mistake of thinking, “That won’t happen to me.”
Several factors play a role in wounds and infections in diabetics:
- Diabetes can lead to a weakened immune system, which can increase the time needed for healing.
- When blood glucose remains high, it impairs the functioning of white blood cells, resulting in an inability to fight bacteria.
- Uncontrolled diabetes is associated with poor circulation. As circulation slows, red blood cells move more slowly, which means it becomes more difficult for the body to deliver nutrients to wounds. As a result, injuries heal slowly, or may not heal at all.
- Neuropathy or nerve damage, one of the many diabetes side effects, can also make matters worse.
There are times when as a diabetic you may experience minor trauma to your feet in the form of a small cut or bruise. This can be particularly challenging especially if you are out of town or will have to wait a day or 2 before you can get to your foot doctor. The following are a few tips you can use until you can see your healthcare provider:
Clean and Check the Wound
Before you start any kind of treatment, clean the affected area thoroughly. Proper cleaning of a wound will ensure optimal healing and reduce the risk of infection.
- The easiest way to clean minor wounds is with clean running water. This will help remove as much dirt, debris, and bacteria as possible. Use cool water under moderate pressure and a mild soap to wash the wounded area. If you do not have filtered water, use boiled and cooled water, or distilled water.
- Gently pat the area dry using a clean towel.
- Apply a thick coat of any antiseptic cream.
- Cover it with a sterile dressing or bandage.
- Change the dressing frequently, at least 2 or 3 times daily.
At the same time, no matter how minor a wound is, if you are diabetic you need to check the wound more often.
Whenever you remove the bandage, thoroughly check the affected area for any sign of infection. If you notice any abnormalities, address it with your doctor immediately.
Manage Blood Sugar Level
To reduce the risk of infection from minor wounds and cuts, it’s also important to keep a close eye on your blood sugar level.
High levels of glucose in the blood can delay the healing process and even increase the risk of infection.
A 2013 study published in Plastic and Reconstructive Surgery found that people undergoing surgery for chronic diabetes wounds were more likely to fully heal if their blood glucose was well-controlled at the time of surgery. So, when suffering from any kind of wounds, it is imperative to control your blood sugar level. You can do this by eating healthy and diabetic-friendly foods and incorporating at least 30 minutes of physical activity into your daily routine.
Also, do not forget to take your medicines and insulin on time and as directed by your doctor.
Check your fasting and postprandial (post-meal) blood sugar levels several times each day, and see your doctor immediately if the levels are high.
Honey can be used to treat wounds in diabetic people.
Honey promotes rapid wound healing by stimulating tissue regeneration, angiogenesis and fibroblast growth. Also, the osmotic effect of honey keeps the wound moist and clean, which is important for healing.
Plus, the anti-inflammatory action of honey reduces pain and swelling. A study published in the Journal of Wound Care in 2008 analyzed the safety and efficacy of a new honey ointment on diabetic foot ulcers and found it to be a promising, safe and conservative local treatment (3).
A 2014 study published in the Journal of Ayub Medical College reports that use of honey significantly reduced the rate of amputation and improved wound healing when used for wound dressings in chronic diabetic foot ulcers (4).
Another 2014 study published in Evidence-Based Complementary and Alternative Medicine found honey to be a safer, faster and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs (5).
- Clean the affected area with plain water to remove dirt and germs.
- Rub honey on a wound dressing and carefully wrap it around the affected area.
- Change the bandage 3 or 4 times a day.
- You can use aloe vera to treat wounds in diabetic people. Aloe vera has analgesic, anti-inflammatory, and soothing properties.
- Also, its gel is rich in phytochemicals that can ease the pain, reduce inflammation, increase the moisture content in the skin and promote healing.
A 1998 study published in the Journal of Ethnopharmacology indicated that aloe vera treatment of wounds in diabetic rats may enhance the wound healing process by influencing phases, such as inflammation, fibroplasia, collagen synthesis, and maturation, and wound contraction. The study emphasizes that these effects may be due to the reported hypoglycemic effects of the aloe gel. Later, a study published in the Australasian Medical Journal in 2012 found that an aloe vera gel preparation is cheap and was effective even against multi-drug resistant organisms as compared to the routinely used topical antimicrobial agents for the treatment of infected leg ulcers (7).
- Cut open an aloe vera leaf and extract the gel.
- Apply this gel on the wound and allow it to dry on its own.
- Clean the area with warm water and pat it dry with a soft towel.
- Repeat several times a day until the wound heals completely.
Turmeric is a natural antiseptic and antibiotic agent that can be used to heal minor wounds and prevent infection among diabetic people.
It is the compound curcumin in turmeric that improves wound healing by modulating collagen and decreasing reactive oxygen species.
A study published in Life Sciences in 2014 highlighted the wound-healing properties of curcumin, also providing evidence for its ability to enhance collagen deposition, granulation tissue formation, tissue remodeling and wound contraction. A 2015 study published in Tropical Medicine & Surgery reports that curcumin possesses potent anti-inflammatory, antioxidant and anti-infective properties, which make this molecule a worthy candidate for wound healing and is beneficial in the management of diabetic foot ulcers (9).
- If a minor wound, cut or abrasion is bleeding, apply some pure and organic turmeric powder directly on the affected area to help stop the bleeding.
- To promote wound healing, mix ½ tablespoon of turmeric powder in enough coconut oil to form a paste. Apply it on the wound 2 or 3 times a day to reduce pain and prevent infection.
You can also mix 1 teaspoon of turmeric powder into a glass of hot milk. Drink it daily for a few days before going to bed.
Coconut oil can effectively heal wounds in diabetic people.
The oil is effective due to its amazing antibacterial, anti-inflammatory, moisturizing and healing properties. It can even keep infections at bay and prevent scarring.
It even helps to deal with the pain and swelling associated with wounds and abrasions. A 2018 study published in the European Journal of Anatomy found virgin coconut oil to be better than silver sulfadiazine cream in the healing of diabetic wounds via promoting collagen and re-epithelialization and synthesize as well as increasing the wound closure rate and total protein content (10).
- Apply extra-virgin coconut oil on the wounded area. Put a bandage over it to seal in the moisture. Reapply the oil and change the bandage 2 or 3 times a day. Use this remedy for several days to prevent scarring.
- Also, aim to include 1 to 2 tablespoons of extra-virgin coconut oil in your daily diet.
When it comes to wound healing, olive oil is also very effective. It’s rich in omega-3 fatty acids that can actually reduce inflammation, which can help speed up the wound healing stages. Its monounsaturated oleic and palmitoleic acids, in particular, help in wound healing. A study published in the Journal of Diabetes & Metabolic Disorders in 2015 indicated that olive oil in combination with routine care is more effective than routine care alone, and is without any side effect. However, further studies are required to confirm these results (11).
Another 2015 study published in Burns found that taking olive oil orally increases the body’s ability to recover from a burn-related wound (12).
Include olive oil in your diet by using it in your salads, smoothies or soups.
Eat a Healthy Diet
For maintaining your blood sugar level and accelerating the healing process, your diet plays a key role.
You must try to eat foods that are high in protein, low in carbohydrates, low in calories and full of nutrition.
It is also important to get enough protein, as it helps repair the skin and other tissue that have been damaged. Pulses, legumes, and dairy products are some of the good sources. Also, eat more foods rich in vitamins C and E, as these powerful antioxidants boost the immune system to fight off infections and also promote quick healing. Some foods rich in vitamin C are oranges, tomatoes, strawberries, broccoli, and red peppers.
Eat high-fiber foods like fruits, vegetables, beans, whole grains, and nuts. Also, choose healthy unsaturated fats.
It’s not only what you eat but also how much you eat that matters. Be careful about portion sizes and try to eat 5 or 6 small meals rather than 2 or 3 large meals.
- Make sure you never walk barefoot, even inside your home.
- It is important to check the inside of your shoes for stones.
- Protect your feet by letting your podiatrist handle even minor foot issues.
- Don’t try to remove calluses or warts yourself.
- You can apply a cold compress to the affected area if there is bruising or swelling.
- Do not wear clothes that can cling or rub the area and worsen the wound.
- Do not pick or scratch at scabs.
- Avoid smoking and consuming alcohol, as they will delay the healing process.
- Boost your protein intake to speed up recovery time.
- Drink plenty of water to keep the body and skin hydrated.
- Every day before going to bed, give your feet a thorough check for signs of blisters, sores, cuts, scrapes or any small injuries that can lead to a significant problem.
- You can restrict diabetic foot infections through regular washing and cleaning.
- Choose shoes carefully that fit both feet and don’t cause blister or sores on the feet.
The Releford Foot and Ankle Institute is dedicated to reducing the amputation rate both domestically as well as internationally. I’ve been practicing for over 30 years and I’ve seen personally how some of these wound care remedies can work.