Points to clarify with patients to avoid common misconceptions about foot health and ulceration.a
| Q: | What is a diabetic foot ulcer? |
| A: | The word ulcer is derived from the latin word ulcus which means sore or wound. The generally accepted definition of a diabetic foot ulcer is a penetration of the skin below the ankle in a person with diabetes, irrespective of size and duration. |
| Q: | What is the greatest risk to foot health? |
| A: | Wounds on the feet, however small, pose a risk because they could be the entry point for infection. It is therefore important to protect the feet from any skin damage. |
| Q: | Can infection occur if the feet are clean? |
| A: | Bacteria can enter through a small opening in the skin, even if foot hygiene is excellent. Infection can occur very quickly in a person with diabetes and may be difficult to treat. |
| Q: | What happens if the blood supply to the feet is affected? |
| A: | Diabetes can damage blood vessels in the legs and feet. This can result in difficulties with the healing of even small sores on the feet. If infection occurs treatment with antibiotic medication may not be effective. It is therefore important to avoid any risk of skin damage, for example by walking around without footwear. |
| Q: | Is numbness caused by poor blood supply to the feet? |
| A: | Numbness in the feet does not indicate poor blood supply or that tissue is dying and at risk of becoming gangrenous. However, it does mean that some sensitivity is lost and an injury may not be painful. Any break in the skin is potentially serious, even if it is not painful. The feet should always be well protected and inspected for any changes on a daily basis. |
↵a The questions are based on areas where participants were found to have uncertainties or misunderstandings. The answers are based on the guidance for patients issued by NICE,45 medical textbooks,9,10 and input from clinicians. However, the topics and answers are not exhaustive and should not replace clinical guidelines.