4 doctors weighed in:

HI!I HAVE DIABETES. AND HAVE A WOUND ON MY LEFT LEG .FOR A YEAR NOW I'VE WAS IN THE HOSPITAL JUST BEFORE XMAS. AND NOW THE WOUND KEEPS GETTING A SLIME ON IT . THE NURSE AND DOCTOR HAVE PUT MEDA HONEY ON IT NOW .BUT THEY HAVE USED TENDER WETS -PRISMA -SIL

4 doctors weighed in
Dr. Howard Fox
Podiatry
1 doctor agrees

In brief: I

I agree wholeheartedly with dr. Christensen's answer, and would like to add my own thoughts.
It's been my experience too many doctors, of all specialties, get hung up on treatment of leg and foot ulcers instead of focusing attention on the cause. An ulcer is a symptom, not a disease. The key to the successful closure of an ulcer is to address the underlying cause. For instance: chronic venous insufficiency from varicose veins can cause an ulceration on the inner lower 1/3 of the leg. Since the underlying cause is blood stagnation, the blood needs help fighting gravity, so compression dressings are the most helpful. Diabetic foot ulcers over pressure points are the result of pressure and a lack of sensation. Thus, the treatment must address pressure above all. Chronic high blood pressure can produce leg ulcers on the outside of the lower legs. It doesn't matter what sort of goo is applied to these ulcers. To close them, the hypertension must be adequately addressed. Ulcers that arise from ischemia (lack of blood circulation) will only close if the poor circulation is addressed. In short, if the underlying cause of the ulcer is properly addressed, you could put mayonnaise on it and it will close. Likewise, if the underlying cause of an ulcer is not addressed, all the topical dressings, honey, antibiotics or the latest "miracle" dressing won't make a difference. So my unsolicited $0.02 here is to find someone who will take the time and effort to make a diagnosis as to why you've ulcerated. That is the key to closing this thing.

In brief: I

I agree wholeheartedly with dr. Christensen's answer, and would like to add my own thoughts.
It's been my experience too many doctors, of all specialties, get hung up on treatment of leg and foot ulcers instead of focusing attention on the cause. An ulcer is a symptom, not a disease. The key to the successful closure of an ulcer is to address the underlying cause. For instance: chronic venous insufficiency from varicose veins can cause an ulceration on the inner lower 1/3 of the leg. Since the underlying cause is blood stagnation, the blood needs help fighting gravity, so compression dressings are the most helpful. Diabetic foot ulcers over pressure points are the result of pressure and a lack of sensation. Thus, the treatment must address pressure above all. Chronic high blood pressure can produce leg ulcers on the outside of the lower legs. It doesn't matter what sort of goo is applied to these ulcers. To close them, the hypertension must be adequately addressed. Ulcers that arise from ischemia (lack of blood circulation) will only close if the poor circulation is addressed. In short, if the underlying cause of the ulcer is properly addressed, you could put mayonnaise on it and it will close. Likewise, if the underlying cause of an ulcer is not addressed, all the topical dressings, honey, antibiotics or the latest "miracle" dressing won't make a difference. So my unsolicited $0.02 here is to find someone who will take the time and effort to make a diagnosis as to why you've ulcerated. That is the key to closing this thing.
Dr. Howard Fox
Dr. Howard Fox
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1 doctor agrees

In brief: Persistent

Persistent wounds are as mentioned by the previous commenters, a symptom of an underlying problem, almost always vascular (circulation related).
Usually the first order of business is to perform a vascular ultrasound of the legs to evaluate the circulation, both of the veins and arteries. Typically ulcers caused by veins are on the ankles, and arterial ulcers are on the toe or instep part of the foot. Diabetics notoriously can have normal large and medium vessels, but disease in the smaller vessels, meaning, that even if your ultrasound shows normal arteries, you can still have arterial problems. Small vessel disease is tested for by using skin perfusion testing, or toe pressures. These tests can only be done at a specific vascular lab, and you should probably see a vascular surgeon to evaluate.

In brief: Persistent

Persistent wounds are as mentioned by the previous commenters, a symptom of an underlying problem, almost always vascular (circulation related).
Usually the first order of business is to perform a vascular ultrasound of the legs to evaluate the circulation, both of the veins and arteries. Typically ulcers caused by veins are on the ankles, and arterial ulcers are on the toe or instep part of the foot. Diabetics notoriously can have normal large and medium vessels, but disease in the smaller vessels, meaning, that even if your ultrasound shows normal arteries, you can still have arterial problems. Small vessel disease is tested for by using skin perfusion testing, or toe pressures. These tests can only be done at a specific vascular lab, and you should probably see a vascular surgeon to evaluate.
Dr. David Greuner
Dr. David Greuner
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Dr. Stephen Christensen
Family Medicine

In brief: I'm

I'm sorry you're having so much trouble with this persistent wound.
Unfortunately, your story is not at all unusual; diabetic leg and foot wounds can be maddeningly resistant to treatment. Despite the chronic nature of your wound, it sounds like your doctor has things pretty well in hand. The science of wound care is incredibly dynamic, and new treatments emerge on an almost weekly basis. Hyperbaric oxygen therapy, acoustic wave therapy, biologically active salves, and a wide array of dressings are available for dealing with diabetic wounds. However, one critical and oft-neglected aspect of wound care is the scrupulous management of blood glucose levels, which is largely under the patient's control. If your blood sugar is running higher than it should (fasting sugars should be in the 90 to 130 range and daytime sugars should be below 150), your wound will be slower to heal. In addition, if you smoke (you'd be amazed at how many diabetics do), your wound simply won't heal. I've attached a link that provides vignettes on a variety of new approaches to diabetic wound care. After reviewing this information, talk to your doctor about your options. I hope things take a better turn soon! http://www.Diabeteshealth.Com/browse/complications-and-care/wound-care/.

In brief: I'm

I'm sorry you're having so much trouble with this persistent wound.
Unfortunately, your story is not at all unusual; diabetic leg and foot wounds can be maddeningly resistant to treatment. Despite the chronic nature of your wound, it sounds like your doctor has things pretty well in hand. The science of wound care is incredibly dynamic, and new treatments emerge on an almost weekly basis. Hyperbaric oxygen therapy, acoustic wave therapy, biologically active salves, and a wide array of dressings are available for dealing with diabetic wounds. However, one critical and oft-neglected aspect of wound care is the scrupulous management of blood glucose levels, which is largely under the patient's control. If your blood sugar is running higher than it should (fasting sugars should be in the 90 to 130 range and daytime sugars should be below 150), your wound will be slower to heal. In addition, if you smoke (you'd be amazed at how many diabetics do), your wound simply won't heal. I've attached a link that provides vignettes on a variety of new approaches to diabetic wound care. After reviewing this information, talk to your doctor about your options. I hope things take a better turn soon! http://www.Diabeteshealth.Com/browse/complications-and-care/wound-care/.
Dr. Stephen Christensen
Dr. Stephen Christensen
Thank
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