脚溃疡是常见的并发症diabetesthat is not being managed through methods such as diet, exercise, and insulin treatment. Ulcers are formed as a result of skin tissue breaking down and exposing the layers underneath.
它们在您的大脚趾和脚的球下最常见，它们可能会影响到骨头的脚。
All people with diabetes can develop foot ulcers, but good foot care can help prevent them. Treatment for diabetic foot ulcers varies depending on their causes.
与您的医生讨论任何脚步问题，以确保这不是一个严重的问题，因为被感染的溃疡可能会导致截肢。
第一个足底溃疡是排水的迹象from your foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms.
严重的脚溃疡最明显的迹象是黑色组织（称为eschar）周围溃疡。这是由于缺乏健康的血液流向溃疡周围区域的原因。
Partial or completegangrene这是指由于感染引起的组织死亡，可能会出现在溃疡周围。在这种情况下，可能会出现有可能出现的排放，疼痛和麻木。
Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected.
如果您开始看到任何皮肤变色，尤其是变成黑色的组织，或者在似乎被called乱或刺激的区域周围感到疼痛，请与您的医生交谈。
Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 5 using the瓦格纳溃疡分类系统：
- 0：没有开放病变；可能已经治愈了病变
- 1：superficial ulcer without penetration to deeper layers
- 2：deeper ulcer, reaching tendon, bone, or joint capsule
- 3：deeper tissues involved, with abscess, osteomyelitis, or tendonitis
- 4：gangrene in a portion of forefoot or heel
- 5：整个脚的大坏疽
患有糖尿病患者的溃疡最常见的是：
- poor circulation
- 高血糖（高血糖）
- nerve damage
- irr
血液循环不良is a form of vascular disease in which blood doesn’t flow to your feet efficiently. Poor circulation can also make it more difficult for ulcers to heal.
High glucose levels可以减慢感染的脚溃疡的愈合过程，因此血糖管理至关重要。患有2型糖尿病和其他疾病的人通常很难摆脱溃疡的感染。
Nerve damage is a long-term effect and can lead to a loss of feeling in your feet. Damaged nerves can feel tingly and painful. Nerve damage reduces sensitivity to foot pain and results in painless wounds that can cause ulcers.
溃疡可以通过受影响区域的引流来识别，有时并不总是痛苦的明显肿块。
All people with diabetes are at risk for foot ulcers, which can have multiple causes. Some factors can increase the risk of foot ulcers, including:
- poorly fitted or poor quality shoes
- poor hygiene (not washing regularly or thoroughly or not drying the feet well after washing)
- improper trimming of toenails
- alcohol consumption
- eye disease from diabetes
- heart disease
- 肾脏疾病
- obesity
- 烟草使用（抑制血液循环）
糖尿病足溃疡在老年男性中也最常见。
远离脚，以防止溃疡疼痛。这称为卸载，对所有形式的糖尿病足溃疡都有帮助。步行的压力会使感染变得更糟，并扩大溃疡。
Your doctor may recommend wearing certain items to protect your feet:
- shoes designed for people with diabetes
- 演员
- foot braces
- compression wraps
- 鞋子插入以防止玉米和老茧
Doctors can remove foot ulcers with a debridement, the removal of dead skin or foreign objects that may have caused the ulcer.
感染是脚溃疡的严重并发症，需要立即治疗。并非所有感染都以相同的方式治疗。
溃疡周围的组织可能会被送到实验室，以确定哪种抗生素会有所帮助。如果您的医生怀疑严重的感染，他们可能会命令X射线检查骨骼感染的迹象。
Infection of a foot ulcer can be prevented with:
- foot baths
- disinfecting the skin around an ulcer
- keeping the ulcer dry with frequent dressing changes
- enzyme treatments
- dressings containing calcium alginates to inhibit bacterial growth
Medications
您的医生可能会开处方抗生素，抗白皮书或抗凝结药物，以治疗您的溃疡，即使在预防或抗抑郁治疗后感染也会进展。
Many of these antibiotics attackStaphylococcus aureus，，，，bacteria known to cause staph infections, orß-haemolytic Streptococcus，，，，which is normally found in your intestines.
与您的医生讨论其他健康状况，您可能会增加这些有害细菌（包括艾滋病毒和肝脏问题）感染的风险。
外科手术
Your doctor may recommend that you seek surgical help for your ulcers. A surgeon can help alleviate pressure around your ulcer by shaving down the bone or removing foot abnormalities such as bunions or hammertoes.
You will likely not need surgery on your ulcer. However, if no other treatment option can help your ulcer heal, surgery can prevent your ulcer from becoming worse or leading to amputation.
According to a 2017 review article in theNew England Journal of Medicine，，，，more than half of diabetic foot ulcers become infected. Approximately20％of moderate to severe foot infections in people with diabetes lead to amputation. Preventive care is crucial.
Closely manage your blood glucose, as your chances of diabetes complications remain low when your blood sugar is stable. You can also help prevent foot problems by:
- 每天洗脚
- 保持脚趾甲的修剪，但不要太短
- keeping your feet dry and moisturized
- changing your socks frequently
- 看到一名足病医生进行玉米和愈伤组织去除
- wearing proper-fitting shoes
脚溃疡在接受治疗后可以返回。如果该区域再次加剧，则可能会感染疤痕组织，因此您的医生可能建议您穿着专门为糖尿病患者设计的鞋子，以防止溃疡返回。
如果您开始在麻木区域周围看到黑色的肉，请立即去看医生以寻求感染的脚溃疡治疗。如果未经治疗，溃疡会引起脓肿并扩散到脚和腿上的其他区域。
在这一点上，通常只能通过合成皮肤替代品通过手术，截肢或降低皮肤丧失的皮肤来治疗溃疡。
提早捕获时，可以治疗脚步溃疡。如果您在脚上发出酸痛，请立即去看医生，因为您等待时间越长，感染的可能性就会增加。未经治疗的感染可能需要截肢。
While your ulcers heal, stay off your feet and follow your treatment plan. Diabetic foot ulcers can take several weeks to heal.
Ulcers may take longer to heal if your blood sugar is high and constant pressure is applied to the ulcer.
Remaining on a diet that helps you meet your glycemic targets and off-loading pressure from your feet is the most effective way to allow your foot ulcers to heal.
Once an ulcer has healed, consistent preventive care will help you stop an ulcer from ever returning.