A wound is a break in the skin. Any wound that does not show improvement in four weeks or is not totally healed in eight weeks is considered to be a chronic, non-healing wound. Approximately six million people in the United States suffer from chronic, non-healing wounds, and this number is growing steadily. Patients over the age 65 are the most frequent chronic wound sufferers. People with diabetes and venous insufficiency, are among those who most commonly develop chronic wounds. The ability for wounds to heal properly is determined by ensuring adequate blood supply, proper wound care techniques, and control of coexisting medical problems.
It is estimated that 25% of diabetics will develop a foot ulcer and 70% of those patients will suffer from a recurrent wound within 5 years. If wounds are left untreated, they can lead to amputation. It is estimated that every 30 seconds a lower limb is amputated somewhere in the world because of a diabetic wound.
Every 30 seconds, somewhere in the world, someone loses a lower limb as a result of diabetes. Diabetes and wounds are a dangerous combination. A diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 25 percent of patients with diabetes.
Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes.
An arterial ulcer is caused by arterial insufficiency. Such ulcers are found in patients with arterial circulatory disorders such as hypertension, diabetes and arteriosclerosis. Because nicotine enhances vasoconstriction, smokers are also prone to these.
Arterial ulcers are small, regularly shaped and deep. Usually they occur on the tip of toes, heels or sides of the feet and are covered with eschar (or scab).
A Venous Ulcer is a wound resulting from poorly working one-way valves in the veins of the legs. Pooling of blood occurs, increasing internal vein pressure and leading to leakage of fluid into the tissues. Edema constricts the capillaries, which leads to tissue death.
Venous ulcers are usually superficial, irregular in shape and drain water like fluid.