Last updated: April 2020
Next review: April 2022
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You have been given this leaflet because you have developed an ulceration on your foot.

An ulcer is a break in the skin or a wound that is difficult to heal. They occur anywhere on the foot as a result of any minor skin injury and are prone to infections.

If you have diabetes, about 1 in 10 people develop a foot ulcer at some point in their lifetime.

Most ulcers heal without complications however they can be severe and in a small number of cases lead to surgery and amputation. Therefore it is important to discuss and follow the medical advice agreed during your clinic appointments.

If you have been prescribed antibiotics, take them regularly. Report any problems (rashes, nausea or diarrhoea) to your doctor immediately.

Advice on looking after your ulcer

An ulcer may develop dead tissue and hard skin that either covers the wound entirely or surrounds it at the edges. A podiatrist may decide to remove this with a scalpel (a process known as debridement) to completely expose the wound and to be able to fully examine it and reduce the risk of infection from the dead tissue. This treatment may result in the wound appearing larger. It is generally a painless procedure and can be carried out at your local health centre or clinic.

If the dead tissue is not removed the ulcer is likely to take longer to heal and this will increase the risk of infections occurring.

A dressing will be carefully chosen and applied to the ulcer to keep the area clean and at a constant temperature to encourage healing. It is important to keep this dressing clean and dry. Getting the dressing wet may prevent healing or allow bacteria to enter the ulcer, causing infection.

Unless you have very poor circulation (blood supply), elevate your foot and REST (try not to walk on it) for the majority of the day.

Walking on an ulcerated foot will slow the healing process and make the ulcer much worse.

You may be given a temporary shoe, insole or boot from the podiatrist to help reduce the pressure on your ulcer. You should follow the advice given to you when the footwear is issued and should wear it whenever you are weight-bearing, even at home.

If your ulcer is unhealed after several weeks of treatment, you may be referred to a specialist hospital ulcer clinic.

Smoking directly reduces the circulation to the feet and will slow the ulcer healing. You should speak with your GP or nurse if you would like help to stop smoking.

If you have diabetes, you should aim to control your diabetes as best you can. If you are unsure what is ‘normal’ for you, speak with your GP or diabetes nurse. Ask for advice from your diabetes team if you are struggling to control your diabetes.

Even after your ulcer has healed, you will need to take special care of your feet to prevent another ulcer developing. You may need to see a Podiatrist regularly for preventative care.

Infection

You should pay close attention to any of these danger signs when checking your feet as they may indicate infection that requires antibiotics or a change in antibiotics if you are already taking them:

• Swelling – Has your shoe become tighter recently
• Colour change – is there any reddening of the skin around the ulcer site or dressing? Are there any bluish marks like bruising or is the skin going black?
• Heat – does your foot feel warmer than usual or compared to the other foot?
• Is there discharge or pus – has your ulcer become wet where it was dry before? Is there more blood or pus discharging from it?
• Have you developed new ulcers or blisters?
• Does its smell? – Is there a new unpleasant smell from your foot?
• Do you feel unwell with fever or flu-like symptoms?
• Are your blood sugars (glucose) raised for no obvious reason?

If the answer to any of these questions is ‘yes’ contact your GP or podiatrist immediately – do not wait until your next appointment. If they are not available and your foot has become red, warmer, or swollen, or you feel unwell, attend A&E.