What is a diabetic foot ulcer?
Long-standing diabetes damages the small nerves of the foot, so pressure and injury stop being felt. It also accelerates arterial disease, reducing the blood supply available for healing, and impairs the immune response to infection. A minor blister, a shoe rub or a cut therefore becomes an ulcer, and the ulcer becomes deep.
Assessment has to answer three separate questions: how much sensation is lost, how good is the arterial supply, and how deep does the infection go — including whether it has reached bone. Treating only the wound while ignoring the circulation is the most common reason a diabetic foot fails to heal.
Symptoms to watch for
- An open sore or callus with a break in the skin, often on the sole, heel or toe
- Discharge, odour or staining on socks and footwear
- Redness, warmth and swelling spreading up the foot
- Numbness, tingling or burning in the feet
- A foot that is painless despite an obvious wound
- Black or blue discolouration of a toe
- Fever or rising blood sugars with no other explanation
When to seek urgent care
Spreading redness up the foot or leg, foul-smelling discharge, a black area, or fever with a foot wound needs same-day assessment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For diabetic foot ulcers that usually means:
- Wound assessment with probing for depth and bone involvement
- Neuropathy testing with monofilament and vibration sense
- Pulse examination, ankle-brachial index and toe pressures
- Arterial duplex ultrasound and angiography where perfusion is inadequate
- Deep tissue culture rather than surface swab, to guide antibiotics
- X-ray or MRI where osteomyelitis or Charcot foot is suspected
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- DebridementRemoving callus, slough and dead tissue converts a chronic wound into one that can heal, and reveals its true depth.
- Infection controlTargeted antibiotics based on deep culture, with urgent drainage of any collection or spreading soft-tissue infection.
- RevascularisationWhere arterial supply is inadequate, angioplasty or bypass restores the blood flow the wound needs to close.
- OffloadingTotal-contact casting, removable walkers and pressure-relieving footwear take load off the ulcer — this is as important as any dressing.
- Wound careDressings matched to the wound bed, with negative-pressure therapy in selected deep or post-surgical wounds.
- Minor amputation and reconstructionWhere tissue is unsalvageable, limited surgery preserves a functional, weight-bearing foot.
- PreventionGlycaemic control, footwear assessment, daily foot inspection and regular review to stop the next ulcer forming.
Common questions
It varies widely with depth, infection and blood supply. Superficial ulcers with good circulation can heal in weeks; deep or ischaemic ulcers take months and need the circulation corrected first. No timeline can be promised.
Because a small wound with poor arterial supply will not heal no matter how it is dressed. The test identifies whether revascularisation is needed.
Daily foot checks, properly fitted or custom footwear, prompt attention to any blister or callus, good glucose control and regular podiatric and vascular review substantially reduce recurrence.
Book a consultation in Guntur
Diabetic Foot Ulcers is assessed and treated by Dr. Vijay Kumar Vishnumolakala, MS, MCh, at our Kothapeta clinic. Request an appointment or call +91 00000 00000.