Nonsurgical Treatment for Diabetic Foot Ulcers
To help a diabetic foot ulcer heal, doctors at NYU Langone clean and disinfect the area. If the ulcer is infected, your doctor prescribes antibiotics to clear it up and prevent it from traveling to a bone in the foot.
Your doctor can refer you to an NYU Langone vascular specialist for additional medication if you have lower extremity arterial disease, a condition that impairs blood flow to the legs and feet and can cause an ulcer to heal more slowly.
NYU Langone doctors recommend regular wound care for foot ulcers, as well as other therapies.
As your doctor cleans and disinfects the ulcer, he or she also removes any dead tissue surrounding it. After the wound is clean, the doctor applies bandages to keep the area sterile while it heals.
Your doctor can show you how to clean and dress the wound at home and may recommend using a topical antibacterial ointment to help speed healing and prevent further infection.
Daily wound care should continue until the wound has healed. People with diabetes and lower extremity arterial disease often heal slowly, so it may take weeks or months for a foot ulcer to heal completely.
Hyperbaric Oxygen Therapy
NYU Langone’s Helen L. and Martin S. Kimmel Hyperbaric and Advanced Wound Healing Center at the Ambulatory Care Center is the only outpatient facility in Manhattan that offers monoplace chamber hyperbaric oxygen therapy. Doctors prescribe this treatment to help speed the healing of soft tissue damage caused by a foot ulcer.
In this therapy, a person lies on his or her back on a comfortable bed inside an enclosed, transparent chamber. The chamber is connected to a machine that fills the space with 100 percent oxygen. Breathing pure oxygen increases the amount of oxygen in the bloodstream ten-fold. Oxygen-rich blood can significantly speed healing of a foot ulcer by stimulating the growth factors and stem cells that help repair damaged tissue.
For the best results, most people need multiple sessions of hyperbaric oxygen therapy. Each session takes about two hours. You can listen to music or watch TV during therapy.
Severe foot ulcers may take weeks or months to heal, even with oxygen therapy. The treatment has no side effects.
Custom Orthotics and Braces
To relieve pressure from an ulcer and help it heal, NYU Langone doctors can provide custom-fit orthotic shoe inserts or braces.
Orthotics, or shoe inserts, help redistribute the weight of your body across the bones and joints of your foot while you walk. These inserts are firm but soft and may contain foam or gel to support your foot and make walking more comfortable.
Our doctors can create inserts with soft, donut-shaped padding to surround and support an ulcer. This helps relieve pressure and protect the ulcer from friction when you wear shoes. A custom shoe insert can also shift weight away from the area of the injury to further relieve pressure and help the ulcer heal.
If your doctor recommends taking more weight off of the affected foot, he or she can provide a custom-fit brace that is worn over the foot and leg. There are many types of braces. One version, called a “patellar tendon bearing” brace, shifts the weight of the body off of the affected part of the foot and onto the strong tendon in the front of the knee, called the patellar tendon.
Our diabetic foot specialists take a mold of your foot to ensure that the custom orthotic insert or brace fits you well and is comfortable. It takes about two weeks for the device to be made, at which time your doctor schedules an appointment to show you how to use it.
If a foot ulcer has become infected, a doctor prescribes antibiotics. This medication is usually taken by mouth and fights infection by killing bacteria. The length of time you need to take the medication varies based on the extent of the infection.
If an infection has spread to tissues or bone surrounding the wound, your doctor may recommend antibiotics given through a vein with intravenous (IV) infusion. This delivers the medication into the bloodstream and helps the body fight infection more quickly.