Diabetic Ulcer

Jenna Wishnew, MD, FACS

General Surgeon located in Richardson, TX

A diabetic foot ulcer is a painless ulcer that usually develops on the pressure points at the bottom of the foot in diabetic patients caused by an injury and worsened from neuropathy or lack of normal sensation associated with altered feelings of pain, heat or cold. Diabetic neuropathy often leads to repetitive stress to skin tissues, breakdown of overlying tissue, and eventual ulceration.


- Poor blood sugar control

- Calluses

- Foot deformities

- Improper foot care

- Ill-fitting footwear

- Underlying peripheral neuropathy



- Age > 65 due to reduced subcutaneous fat and capillary blood flow

- Diabetic duration

- Smoking

- Obesity

- Hypertension

- Poor ankle-brachial index (ABI) indicating that the legs and feet aren't getting as much blood as they need

- High neutrophil/lymphocyte ratio as a marker of systemic inflammation associated with poor survival and increased morbidity with chronic 



- Management of blood glucose and underlying health conditions

- Pressure offloading

- Wound dressings

- Surgical debridement (Hyperlinked)

- Chemical debridement (Hyperlinked)

- Skin substitute graft (Hyperlinked)

- Skin graft (Hyperlinked)

- Hyperbaric oxygen therapy (Hyperlinked)