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Helping Your Diabetic Foot Ulcer Heal by Removing Pressure
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- Опубліковано 15 сер 2024
- Free Resource: www.FootUlcerBo...
To Request an appointment with Dr. Schneider: referdrschneide...
There's a saying in the wound healing world that what you take off a wound is as important as what you put on it. My name is Dr. Andrew Schneider and I'm a podiatrist in Houston, TX. In previous videos, we've
discussed using wound dressings to help your diabetic foot ulcer to heal. In today's video I'm going to discuss how to remove pressure from a diabetic foot ulcer to help it heal quicker.
A major factor in the formation of a diabetic foot ulcer is the persistent pressure that causes the wound. This pressure causes an inflammatory reaction which ultimately leads to the breakdown of the tissues and formation of the wound. With that in mind, it's important to manage the pressures that contributed to the formation of the wound in the first place. This is called offloading the wound.
Here's the thing. Most people are receptive to having a dressing regimen, being prescribed medication, and even regular office visits to manage the ulcer. When I start talking to them about offloading the wound, there is
usually some pushback. That's because they don't want their mobility impaired. Even if it's the mobility that's preventing the foot ulcers from healing. The gold standard for healing diabetic foot ulcers is a total contact cast. This is exactly what it it sounds like. It is a below-knee cast that is applied to control the pressures and offload the wound. It has it's drawbacks. however. First, it needs to be applied exactly right. If it creates an area of new pressure, you may risk a new ulcer forming.
An alternative that has proven almost as effective is a removable fracture boot. Although first glance shows this to be a great answer to healing your diabetic foot ulcer, the problem lies with the boot being removable. In fact, there was a study done that showed that if a removable walker was used,
it was used when bearing weight less than 30% of the time. That seriously compromises the removable walkers' efficacy in offloading your wound.
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There are a new generation of walking boots that are designed specifically to heal a diabetic foot ulcer, rather than provide support for a fracture. These boots utilize vacuum technology to make the fit total contact. This suspends the foot in the bead-filled vacuum insert and removes the pressure. Even better, there's a way to make this boot non-removable to ensure that your wound is offloaded whenever you are bearing weight.
Then there are the tried and true methods that work if they're used. These include bed rest, wheelchairs, crutches, and knee scooters. Although people have the purest of intentions, they are only as good as the amount of time they are only used. Other well-meaning attempts at offloading wounds include the use of surgical and wedge shoes. These shoes are useful for transferring, but not so useful for offloading. Even so, they are used often as a means to offload a wound. While they may be better than walking in your own shoes, they still keep a lots of pressure on the foot ulcer itself.
Let me give it to you straight. You've devoted so much time, energy, and resources to heal your diabetic foot ulcer. You've been dedicated to changing your dressings or using a skin substitute to heal your wound. It's time to finish the cycle by properly offloading your wound. When it comes up, you should be receptive to the options.
#DiabeticFootUlcer #Offloading #SavingDiabeticFeet
00:00 Introduction
01:02 How pressure causes a diabetic foot ulcer to form
01:30 The importance of offloading a wound
01:57 Offloading a diabetic foot ulcer with a total contact cast
02:25 Offloading a wound with a removable fracture boot
03:30 Other means to offload a diabetic foot ulcer
05:00 How to connect with Houston podiatrist Dr. Andrew Schneider
Thank you so much i would definitely do that i need that help
Thank you Dr. Schneider.
Thanks for your video chat and very clear information
Thanks so much for watching
Dr Schneider, I have an edema ulcer on top of my foot I'm diabetic have had it for 8 wks what can I do
Thank you dr. Schneider.. I’m trying to convince my mom to wear her offloading boot. It’s so difficult 😞
Yes, the boot is big, clunky, and heavy. It’s is so important to wear though. The wound needs pressure off of it to heal.
Thank you Dr Schneider for this channel I have learned Alot from your videos...It is hard to understand what my doctor says so these videos are a blessing to me
I've developed a foot ulcer wound from a callous on the ball of my foot and my podiatrist sent me to a wound care center...The wound care doctor put me in a Total Contact cast and after two weeks it's already showing signs of improvement.Its a fairly deep wound so it may take awhile but since I'm not diabetic and there is no bone infection she thinks it should heal in a reasonable amount of time..She did a cuter and it did show staf infection but she quickly got me on some antibiotics ...What is your opinion of the Total Contact cast and do you think non diabetic foot ulcer wounds heal faster than diabetic foot ulcer wounds ?
I would have to take it off to drive as I have a standard shift suv but it looks easy enough to take on and off. I don't have insurance so my only help is video's like this! Thank you for not keeping these treatment methods an office secret!! I have been dressing my wound with a home made concoction of iodine and Vaseline..a homemade version of black salve or Iodex..good or bad?
It's pretty easy to take on and off. There's a learning curve for sure, but it can be done. Nothing in iodine or vaseline can hurt you. If it helps, it's certainly okay to keep using.
I would love to have a proper off loading boot,but can not locate a size 16...
You’re right. That’s difficult. I just checked and the boots stop at size 15. I’ll let you know if I find one larger
I, had an ulcer that bursted and then gave me cellulites that turned my leg red. I,wound up in the hospital for 11 days and left the hospital with a picc line. I was on antibiotics for 51 days and gave myself throuigh an iv at home. Disease dr was afraid it got in my blood or bones. Got lucky it wasn't. Podaitry put me on a special shoe. It took 4 months for the wound to heal. Podiatry then told me it was ok to walk. 3 days later ulcer came back and here we go again. Now podiatry told me im getting pressure from foot. Now im in a brace to hold arch up and another special shoe that Is for broken toes. Im just irrate that DR should of seen this along time ago. Im just getting tired of going in to office and getting it shaved. aIs their any thing you would suggest DR
A diabetic foot ulcer is frustrating and you are rightfully frustrated. When an ulcer closes, I say that it’s in remission, not healed. It sounds like you were told it was ok to walk on it sooner than it was ready. I know it’s aggravating to have to go often to have the wound debrided, but that’s how it will heal. I hope it heals quickly and without complications.
@@DrAndrewSchneider All this because I tore up my knee with the terrible 3,s. I, was told I got ulcer from not having stability in my right knee. After ulcer healed I, was given the ok to talk to my knee dr about arthroscopy. Finally had it done 7/3/2024, and was told by dr to walk on with walker. I, then noticed a small crack were ulcer was at and started to wear my special shoe for broken toes. Ulcer is healing but now dr podiatry sending me to get a brace done at a place that does braces and limbs. My knee meniscus got scrapped and nothing done to acl due to arthritis behind knee cap. I, feel really down DR Andrew.☹
@@MegaDubbz I can understand why you’re down. I would be too. It sounds like you have good care and I’m happy to hear the wound is healing. Best of luck.
Please info about boot long
The best boot to heal ulcers, in my opinion, is the VacoCast. You can find it here: opedmedical.com/products/#diabetic
I would like to have a pair of off pressure shoes for amputated toes both feet please help
What you need is to visit a podiatrist. You can get an extra-depth shoe with a soft insole and toe filler to fill the area of the amputated toes. If you can't get to a podiatrist, visit an orthopedic shoe store
How can I get one of boot like that?
You can order a boot directly. This is the one I recommend to heal diabetic foot ulcers: opedmedical.com/products/vacocast-diabetic/
Thank you for the information dr!!! I’m diffenitly buying one for my mom. I would like to ask you more about how to change the dressing. Also I have a question dr I have booked an appointment but I haven’t received a reply. How can I contact you for an online consultation?
The boot is a game changer. It's doing great for my patients! Fill out this form and in the comments say that you want to schedule an online consultation. I'll make sure to mention it to my team so they can set it up. www.tanglewoodfootspecialists.com/contact.cfm
@@DrAndrewSchneider Thank you so much dr. I will
My dad has an ulcer on the ball of the bottom of his foot that's about the size of a dime and is roughly 3/16 of an inch deep and he runs a construction business and won't take time off no matter what I tell him. Is there something he could use throughout the day that helps like a shit ton of pads placed under where the wound is?
There are boots that will help offload the ulcer that he can wear during the day. I recommend the VacoCast. You can purchase it here: opedmedical.com/products/vacocast-diabetic/
@@DrAndrewSchneider hi Dr I have been wearing the vaco cast for the past year for a ulcer I have had for about 7.5 years on ball of my foot I am quite active so struggling to heal but a do like the vaco cast as opposed to my previous aircast. ps I am doing a trial for hospital with it to see how it does regards r
How do one treat a diabetic foot that’s affected with bone or veins
I.e the veins are showing. How do one go about it???
I'm a little unclear about your question. Is there a wound where bone is showing through? If that's the case, it's crucial that you get it checked by a specialist who can treat the wound properly.
@@DrAndrewSchneider yes
But those bones are now covered with muscle but the veins are still showing
How I get the boots?
You can order the boots from their website: opedmedical.com/products/#diabetic