2 Easy Steps Can Discourage Wounds, Save Feet

gronerAs a wound care specialist, Dr. Thomas Groner sees dozens of debilitating foot wounds every week and knows that many of them could have been prevented by one of two very easy actions.

“First, it’s very important to look carefully at your feet and let your foot doctor know if you notice anything unusual,” said Dr. Groner, clinical director of the podiatric residency program at the Alliance Community Hospital Wound Care Center.

“Second, it’s important to wear shoes that fit right,” he said.

Although those seem like simple preventive measures, they are often overlooked.

In many cases, that’s because diabetes can blunt the feeling in one’s feet. If a person suffering from such numbness doesn’t physically look closely at his or her feet, warning signs may be missed and poorly fitting shoes could rapidly turn a small wound into a dangerous one.

In other cases, patients may feel the pain of a new wound but conclude it’s too minor to justify a doctor’s appointment, then grow complacent as the wound gets worse.

“There are people who have lost their legs, and it could have been prevented,” Dr. Groner said.

These conditions -- (from top) a heel ulcer, a neurotropic ulcer and dry gangrene -- can often be prevented but can also lead to amputation. (Images courtesy of American Podiatrict Medical Association.)

These conditions — (from top) a heel ulcer, a neurotrophic ulcer and dry gangrene — can often be prevented but can also lead to amputation. (Images courtesy of American Podiatric Medical Association.)

“It’s not uncommon for someone who has lost feeling to wear loose-fitting shoes and get a blister,” he said. “If they don’t notice, that blister can turn into a wound before they see it.

“For people with diabetes, the risk of not feeling a wound is complicated by the greater likelihood that they might step on a sharp object and develop a serious infection without realizing it.”

The APMA has published some compelling statistics about the dangers of wounds. A landmark study in the 1980s found that some 85 percent of amputations in people with diabetes are preceded by a foot ulcer. Other research suggests that more than 80 percent of diabetic lower extremity amputations are preventable (read more here).

Dr. Groner has some suggestions for those who may have lost feeling in their feet:

  • Ask a caretaker or relative to regularly check your feet for you, especially the bottoms of feet where forerunners to serious wounds often start and may go unnoticed for days or weeks.
  • Look into custom-fitted diabetic shoes, which are often covered by insurance. They’re wider and deeper and have a custom insert that’s molded specifically to the patient’s foot. Some insurance plans cover new diabetic shoes every year.

“Since it’s been established that wounds so frequently lead to amputations, I tell my patients that it is important to prevent wounds as opposed to treating them after they occur,” Dr. Groner said.

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