A member asked:

What is the best wound care for a necrotic diabetic foot ulcer?

21 doctors weighed in across 8 answers
Dr. Vasu Brown answered

Specializes in Integrative Medicine

Depends on Bloodflow: If the skin around necrotic area is still healthy only a small portion is necrotic then you can start locally the first week with antibiotic cream to reduce bioburden and keep using local debridement - removedead tissue off the wound site and try to heal the area. Diabetic ulcers respond to oral vitamin k2 - you can read http://vitamink2.Org. I use 10% Phenytoin cream locally http://drbrown.Us.

Answered 9/28/2016

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Dr. Scott Bolhack answered

Specializes in Wound care

Diabetic foot: You need to seek care from wound center or podiatrist as soon as possible. The evaluation of a diabetic foot ulcer requires a careful history, investigation of your neurological status of your feet, an assessment of the blood flow, and a comprehensive treatment plan that may include debridement, cultures, offloading (which is the most important issue most of the time), and testing. Do not delay!

Answered 10/3/2016

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Dr. Adam Teichman answered

Specializes in Orthopedic Foot and Ankle Surgery

Wound Care Center: If you suffer from any diabetic foot wound you need to see help with a certified wound care specialist and podiatric surgeon. Wound care centers specialize in treating all kinds of complicated diabertic and non diabetic wounds. If you are suffering with a necrotic wound seek medical attention, dont delay becuase a wound untreated can lead to limb loss.

Answered 9/28/2016

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Dr. Tharesh Udupa answered

Specializes in Podiatry

Team approach: Depends on what is meant by necrotic. Is there blood flow to the extremity or wound? If not, a vascular or interventional cardiologist need to increase the blood flow to the extremity. A podiatrist is needed to get any bony prominence resected and to offlaod the wound. An endocrinologist is needed to get the diabetes under control if out of control.

Answered 1/5/2014

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Medical care: Best care would imply you are seeing the appropriate people to best deal with this condition. A team approach responsible for keeping your sugar under control, making sure your bloodflow is adequate, offloading the foot if the ulcer is on the bottom of the foot and taking care of all other comornidities. This is not something to do without proper medical attention.

Answered 9/28/2016

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Multiple factors: It’s changing every day. Wound care requires multi-discipline input for proper wound healing. There are multiple modalities and multiple strategies to get a wound closed but it takes a knowledgeable well trained specialist to know when to implement the appropriate treatment during the course of wound healing using evidence based medicine.

Answered 5/17/2016

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Dr. Payam Rafat answered

Specializes in Podiatry

See a professional: Successful treatment of diabetic foot ulcers consists of addressing these three basic issues: debridement, offloading, and infection control. Seek professional assistance.

Answered 2/6/2019

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Maggot therapy: If the wound is necrotic this needs to be removed. Apply maggots to debride the wound. Must make sure the blood supply is adequate for healing. Need to off load the wound. See a wound care specialist.

Answered 8/14/2013

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