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Wound care
Staying on your feet
Diabetic foot ulcers are the biggest cause for hospital admission for people with diabetes, and even when patients receive the optimum standard of care, not all ulcers heal properly. Topical oxygen therapy is emerging as a promising new adjunct to therapy, with scope to heal wounds that standard treatments cannot. So what might it mean for health systems and the patients affected? Abi Millar speaks to podiatrists Dr Paul Chadwick and Dr Windy Cole to fi nd out.
D
iabetic foot ulcers (DFUs) place a huge burden on healthcare systems. Occurring in around 10% of patients with type 1 and 2 diabetes, these slow-healing wounds are problematic for patients and far from straightforward to treat. Around 450,000 people in the UK will develop such an ulcer at some point in their lives, a minority of whom will eventually require amputations. Soberingly, half of DFU patients will die within five years of diagnosis – a higher mortality rate than many cancers.
When blood sugar levels remain persistently high, or fluctuate dramatically over a long-term period,
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the patient can develop neuropathy. This in turn can lead to a loss of sensation in the feet and a lowered capacity for healing – and can spell trouble. Since patients lose their protective response mechanisms to pain, they are unable to detect minor trauma such as blisters or abrasions, which can develop into DFUs if inadequately treated. Although the ulcers don’t always hurt, they do need to be treated to lower the risk of infection and other complications. “The NHS spends around £1bn a year on the management of diabetic foot ulcers, which is equivalent to around 1% of total NHS spend,” remarks Dr Paul Chadwick, visiting professor in
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