Foot ulcers and pressure ulcers can cause serious complications for people with diabetes. However, they are easily treated with early detection. Treatment of ulcers varies with the type and severity of the wound. Physicians can offer the best information regarding the cause of the ulcer and appropriate treatment. Common treatment methods for ulcers include:

• Wound care. Dressings range from ordinary bandages to antibacterial and antiviral coverings. Therapy may included debridement (removal of dead tissue) by chemicals, scalpel or whirlpool treatments. Casts may be applied during healing. Researchers have found that nonremovable casts can increase compliance and allow faster recovery.
  
  
• Antimicrobial medications. Antibiotics can control bacterial infections at the early stage to prevent worsening of the condition and spreading of the infection in the body. Antifungals treat fungus infections.
  
  
• Skin substitutes. A dissolvable mesh containing a product made from the human cells that make connective tissue is placed on the wound. The skin substitute is absorbed, replaces the damaged area and closes the lesion.
  
  
• Topical human growth factor. Gel containing a genetically engineered platelet-derived growth factor is applied to the ulcer. The gel attracts and fosters the spread of the cells that repair wounds and create tissue.
  
  
• Diet. Meals high in protein, vitamins and other nutrients can speed repair of damaged tissues.
  
  
• Exercise. Walking, muscle strengthening, and physical therapy for positioning issues can help resolve pressure ulcers. Some research has found that active people are less likely to develop diabetic foot ulcers than nonexercisers. However, some types of exercise, such as running or other high-impact activities, may be harmful for those who have or are at risk of foot ulcers. Patients are advised to get their physician’s approval before starting an exercise program.
  
  
• Infrared light therapy. The U.S. Food and Drug Administration (FDA) has approved a light-emitting device that features a pad strapped to the foot or other injured area. Dozens of diodes in the pad send painless infrared light into the body. The light may dilate (widen) the blood vessels and encourage new blood vessels to grow. Increased circulation improves sensation and wound healing.
  
  
• Skin grafting. Transplants of skin may be necessary in severe cases.
  
  
• Surgery. Surgery on the blood vessels to improve circulation to the legs might be necessary if blockage is severe and unresolved by noninvasive procedures. Consultation with a vascular surgeon would be a necessary first step. For people with nonhealing foot ulcers and osteomyelitis, surgical removal of dead tissue and restoration of circulation sometimes prevents extensive amputations.

Individuals with poor sensation due to diabetic neuropathy are sometimes offered an Achilles tendon lengthening (ATL) to increase the ankle’s mobility and prevent pressure points on the foot. Another surgical treatment for neuropathy, nerve decompression, may help heal ulcers and prevent amputations.