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Persisting wound on the the toe. Have diabetes. What to do?

My Mom who is 83 years is diabetic and she has this persistent wound under her big toe on her foot . She is being seen by a Wound Care Nurse but she has this callouses or thick dead skin surrounding the wound. How do I remove the calouses without going to the podiatrist. Her wound is not infected but will not close because of this thick dead skin surrounding her wound. Would appreciate your quick response to this query of mine. Thank you. Evangeline
Asked On : Wed, 13 Feb 2013
Answers:  1 Views:  38
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General & Family Physician 's  Response
It seems to be a case of diabetic foot which is one of the commonest complication of uncontrolled diabetes.The cause is multifactorial like neuropathic as well as angiopathic.
Neuropathy leads to sensory dysfunction leading to painless ulcer and autonomic dysfunction leads to drying of skin.
Angiopathy leads to ischaemia and infection leading to delayed wound healing.
Diabetic peripheral neuropathy leads to impaired sensations in lower limbs making the foot vulnerable to trauma.
A non healing foot ulcer may lead to osteomyelitis of tarsal and metatarsal bones.

She must be immediately hospitalised and evaluated properly by doing pus culture and MRI foot to look for osteomyelitis.
She may require surgical debridement along with proper antibiotic therapy.

diabetic foot ulceration is considered the most likely predictor of eventual lower extremity amputation in patients with diabetes mellitus 
Answered: Wed, 13 Feb 2013
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