A foot wound is a breaking of the skin anywhere on the foot.
It can be caused by:
- An injury to the foot, for example from treading on a sharp object
- Pressure or rubbing, for example from a badly fitting shoe.
A foot wound can cause a loss of mobility. Infected wounds can lead to amputation and even death.
Discussion
It is estimated that globally, every 30 seconds, someone has a lower limb amputation due to a diabetic foot wound.
- Do you know anyone who has developed a foot wound?
- Do you know how it started?
- How was it managed?
- Did it heal, or lead to more complications?
Amputation can often be avoided by:
- Preventing foot wounds or
- Identifying and treating foot wounds as soon as they occur.
Read on to learn more about what causes foot wounds, and who is most at risk of serious foot wounds.
Foot wounds can be a serious problem for people who have any of the following health problems:
Problems with feeling (sensation) in the feet
Problems with feeling in the feet means that a person may not feel pain, pressure, heat or touch.
A person with problems with feeling, or no feeling in their feet is at high risk of foot wounds, because they do not feel when something is causing their foot harm.
People with diabetes, leprosy, spinal cord injury or stroke often experience a loss of feeling in their feet, and so they are at risk of a foot wound.
Some people who drink a large amount of alcohol may also have a loss of feeling in their feet and be at risk.
For any person who has problems with feeling in their feet, walking barefoot increases the risk of injury and the development of a foot wound.
Question
Josephina is 45, and has diabetes. She does not have full feeling in her feet and reduced blood flow.
Josephina is a fisher and spends a lot of time at the beach and on a boat. She is often barefoot.
Is Josephina at risk of a foot wound?
Yes, Josephina is at moderate risk because she cannot fully feel her feet and they are not protected by shoes. She could injure her foot on the beach, in the water or on her boat. Reduced blood flow will increase the risk of slow healing and infection.
Reduced blood flow
When there is less blood flow to the feet, a foot wound will take longer to heal and the risk of infection is higher.
People with diabetes, heart conditions and/or kidney disease often have reduced blood flow.
People who smoke may also have reduced blood flow.
Meet Ravi
Ravi is an older man who has diabetes. He stepped on a small piece of broken glass in his house. Because he has less feeling in his foot, he did not notice the cut for a few days. When he became aware of it, he tried to manage the cut himself.
Because of his diabetes, Ravi has poor blood flow to his feet. This meant that the wound did not heal, and soon became infected. The infection spread and Ravi became very ill.
Ravi’s family brought him to hospital. Here he learned that it would be necessary to amputate his foot and lower leg to stop the infection from spreading further. Without the amputation, Ravi could have died.
Question
Prevention of foot wounds can help reduce amputation caused by foot wounds.
What are some things that could have helped Ravi avoid a foot wound?
- Education for Ravi about how to look after his feet, including checking them every day for wounds
- Wearing suitable shoes indoors and outdoors to protect his feet.
Early identification and treatment of foot wounds is another way to reduce amputations.
What might have helped Ravi avoid amputation?
- Ravi could have gone to his local health clinic as soon as he hurt his foot
- Frequent, regular treatment and monitoring of his foot wound by trained health staff
- Regular diabetes review and management.
Unusual foot shape, toe or foot amputation
When we stand, our body weight is spread evenly through our feet as they touch the ground.
When walking, for every step, the foot on the ground carries 1 ½ times a person’s total body weight. Spreading this weight evenly is important.
A change in the shape of the foot can lead to too much pressure on parts of the foot. This can lead to a foot wound.
People with unusual shaped toes or feet, or people who have had a toe or foot amputation, are at risk of developing a foot wound from pressure when weight bearing.
Meet Ruby
Ruby is 55 years old and has diabetes. She has a toe amputation caused by an infected foot wound.
When Ruby walks the weight which used to be distributed equally across her whole foot is now distributed through the part of her foot that remains.
She is at risk of developing another foot wound because of the increased pressure on the remaining part of her foot.
Ruby attends a diabetes clinic regularly to make sure she is managing her health and diabetes. As she is at risk of developing another foot wound, she also attends the diabetic foot clinic. To prevent another foot wound, Ruby has been provided with a special shoe that helps to reduce pressure on the remaining part of her foot. This is called an off-loading device. She also walks with elbow crutches to help reduce the pressure on her foot.
You have completed Lesson one!
In the next lesson you will learn about different types of mobility assistive products.