Patient Education: Diabetic Ulcer Wound Care

What is a Diabetic Ulcer?

A diabetic ulcer is an open sore or wound, most often found on the feet of people with diabetes. High blood sugar can damage nerves and blood vessels, making it harder for wounds to heal and easier for infection to spread.

Causes of Diabetic Ulcers

Poor blood flow to the feet.
Nerve damage (loss of feeling in feet).
High blood sugar that slows healing.
Pressure or injury to the foot (cuts, blisters, stepping on objects).
Poor-fitting shoes.

Prevention

Check your feet every day for cuts, sores, or blisters.
Wash and dry feet daily, especially between toes.
Wear clean socks and well-fitting shoes.
Do not walk barefoot.
Trim toenails carefully (or have a professional do it).
Keep blood sugar under control with diet, exercise, and medicine.
Relieve pressure on your feet—use special shoes, pads, or cushions as ordered.

Treatment (Follow Your Doctor’s Orders)

Wash your hands before touching your wound or dressing.
Clean and cover the wound as directed.
Change dressings as often as ordered by your doctor or nurse.
Take prescribed medicines (antibiotics, pain relievers, or diabetes medicine).
Do not walk on the ulcerated foot—relieve pressure to help healing.
Use special shoes, boots, or crutches if your doctor recommends them.

What is a Compromised Wound Dressing?

A dressing (bandage) is compromised if:

It becomes loose or falls off.
It gets wet, dirty, or soiled.
It no longer fully covers the wound.

What to do if compromised:

Wash your hands.
Replace with a clean, dry dressing if you have supplies.
If you cannot replace it, call your nurse or doctor.

Signs and Symptoms of Complications

Fever or chills.
Red streaks moving away from the sore.
Severe pain or swelling.
A wound that smells bad or drains a lot.

Signs of Infection

Redness, swelling, or warmth around the ulcer.
Yellow, green, or foul-smelling drainage.
Worsening pain.
Skin around the wound breaking down.

Signs the Wound is Getting Worse

The ulcer is getting larger or deeper.
The wound edges are opening.
The sore is not healing or looks worse.
You feel weak, tired, or sick.

Diet for Wound Healing

Eat protein-rich foods (chicken, fish, beans, eggs, tofu).
Eat fruits and vegetables for vitamins that repair skin.
Whole grains give your body energy.
Drink enough water every day.
Important: If you have kidney disease, talk to your doctor or home health nurse before eating more protein. Some foods may not be safe for your kidneys.

When to Contact Your Home Health Nurse or Doctor

If your dressing is compromised and you need help.
If you notice mild swelling, redness, or drainage.
If you run out of wound supplies or medication.
If you have questions about wound care, foot care, or diet.

When to Go to the Emergency Room

Heavy bleeding that does not stop.
Fever and chills with spreading redness.
Severe pain not controlled by medicine.
Large amount of pus or foul odor.
If the wound suddenly gets much worse.

Additional Information

Relieve pressure: Do not walk on the ulcerated foot unless your doctor approves.
Blood sugar control: Keep blood sugar within your target range to help healing.
No smoking: Smoking lowers blood flow and slows healing.
Daily foot care: Always inspect and protect your feet.

Patient Homework/Assessment – True or False

True or False: A diabetic ulcer is an open sore usually found on the foot.
True or False: High blood sugar can make it harder for wounds to heal.
True or False: Poor blood flow and nerve damage can cause diabetic ulcers.
True or False: You should check your feet every day for sores or cuts.
True or False: Walking barefoot is a safe choice for people with diabetes.
True or False: Washing and drying your feet daily helps prevent ulcers.
True or False: Poor-fitting shoes can lead to foot ulcers.
True or False: If your wound dressing is wet or dirty, it is compromised.
True or False: You should leave a compromised dressing in place until the next nurse visit.
True or False: Fever, chills, and red streaks may mean a serious complication.
True or False: Yellow or green drainage may mean infection.
True or False: You should wash your hands before touching your wound or dressing.
True or False: Protein, fruits, vegetables, and water help wounds heal.
True or False: If you have kidney disease, you should change your diet without talking to your doctor.
True or False: Relieving pressure on your ulcer helps healing.
True or False: Severe pain that is not helped by medicine should be ignored.
True or False: Smoking slows wound healing.
True or False: If you run out of wound supplies, you should call your nurse or doctor.
True or False: Heavy bleeding that does not stop is an emergency.
True or False: Keeping blood sugar under control helps wounds heal.

Answer Key with Explanations

True – Diabetic ulcers are most common on the feet.
True – High blood sugar slows the healing process.
True – Poor blood flow and nerve damage increase risk of ulcers.
True – Daily foot checks help catch sores early.
False – Walking barefoot increases risk of injury and ulcers.
True – Clean, dry feet help prevent infections.
True – Poor-fitting shoes cause blisters and ulcers.
True – Wet, dirty, or loose dressings are compromised.
False – Compromised dressings must be changed right away.
True – These are signs of a serious infection.
True – Pus-like drainage often means infection.
True – Handwashing lowers risk of germs entering the wound.
True – Good nutrition and hydration support healing.
False – People with kidney disease must check with their doctor before diet changes.
True – Pressure slows healing; relieving pressure is key.
False – Severe pain must be reported, not ignored.
True – Smoking lowers blood flow and delays healing.
True – Supplies are needed for safe wound care.
True – Non-stop bleeding needs emergency help.
True – Blood sugar control helps wounds heal and prevents new ulcers.