What generally prevents diabetic ulcers from healing?

Circulation: Patients with diabetes develop numbness (neuropathy) in their feet which puts them at risk for getting wounds. Diabetes causes blockages in the small vessels of the feet causing poor circulation. In addition, diabetes affects the immune system and makes it less effective. Put together, diabetic patients are more likely to develop wounds and have a tougher time healing them.

Multiple issues: Healing of any wound requires good circulation, healthy tissues and proper nutrition. In diabetics we also think about neuropathy and pressure relief in addition to management of the blood sugars. Even if all but one of these issues is absolutely perfect the wound may still not heal. Please see a vascular surgeon or wound specialist for further evaluation.

Multiple factors: Multiple causes. Improper removal of all non viable tissue, inability to offload pressure from the area or excessive walking or standing. Infection and poor circulation can prevent healing. Poor sugar control. Poor nutrition, low blood proteins. Kidney status specifically dialysis. The list keeps going.

Many puzzle pieces: Offloading of diabetic foot ulcers, adequate circulation, good nutrition, blood sugar control, regular wound debridement by your physician, and local wound care are essential factors for wound healing. If any of these pieces of the puzzle are missing the final outcome may not be a pretty picture.

Many factors: The most common reason ulcers may have trouble healing: due to uncontrolled blood glucose levels, underlying infection, poor circulation, poor nutrition, too much pressure to the area, inappropriate wound care.