An ulceration is an open wound or break in the skin caused by something other than a cut or an abrasion. Ulcerations are often chronic, meaning that they take an extended amount of time to heal. There are several different causes of ulcerations each of which have different protocols to heal the ulcer.

Ulcerations are most common in diabetic patients. This is due to several complications associated with diabetes. Diabetes causes decreased circulation and decreased sensation in the feet. The decreased sensation in the feet causes the patient to be unable to feel when there is too much pressure being applied to a single area of the foot. People with normal sensation would recognize this by feeling pain. They would then accommodate for it to decrease the pressure in that area. Diabetics with decreased sensation don’t know to compensate. This increased pressure over time wears down the skin and opens the wound.

The decreased circulation in the skin causes a delay in healing. Healing a wound is accomplished by blood delivering healing factors to the skin. When circulation is decreased these factors are not delivered to the skin. Blood is also responsible for delivering oxygen to the skin cells. Like any other part of our body when the cells do not have oxygen they die. This makes the skin much more vulnerable to injury.

Once the skin is broken and an open wound exists it is the job of the immune system to prevent infections. In the case of diabetes the high blood sugars decrease the patient’s immune system. This leaves the diabetic patient more susceptible to infections. Also because they have decreased circulation, as stated above, they are unable to deliver the antibodies to clear the infection.

To heal a diabetic wound the most important factor is taking the pressure off of that area. In some cases this requires the patient to bear no weight with the affected foot. If a patient has a diabetic wound, they often need to be seen on a weekly basis to clear out any dead or nonviable tissue. There are many wound care products available to assist in the healing of the wound. The wound needs to be healed as quickly as possible to prevent infection and possible amputation.

Ulcerations can occur in areas that don’t have pressure applied to them, in patients without diabetes. People with a significant amount of swelling in their lower legs are susceptible to Venous stasis wounds. Venus stasis is a term used to describe swelling in the legs due to breakdown of the system that delivers fluid back to the heart. When the legs swell it applies a significant amount of pressure on the skin of the lower legs. Over time this pressure will cause the skin to breakdown. In these situations the most important first step in healing the ulcerations is to decrease the swelling in the legs. Decreasing the swelling is accomplished by elevating the legs and applying compression to help move the fluid back to the heart. The wound will also be treated weekly with products similar to those used for the diabetic ulcers.

If you are at high risk for having an ulceration then there are many ways of preventing those ulcerations from occurring. It is important to be evaluated and to do everything you can to prevent them from happening. This might prevent a serious complication and possible amputation.