Non-healing wound on the foot

We all get wounds on our feet, sometimes from shoes that have rubbed or by injuring our feet in some other way. Although walking and wearing shoes might slow down healing a bit these wounds should take no more than 4 weeks or so to heal. If your wound is taking longer to heal or there are no signs of healing, it might be a sign of an underlying problem that needs investigating.

What causes diabetic foot ulcers?

Peripheral arterial disease

One cause of poor healing in the lower leg is when not enough blood is getting to our feet. Blood travels from our heart to our feet through our arteries. If our arteries become too narrow, our skin will not get enough blood to allow the wound to heal as normal.

Arteries can become ‘furred’ up by the build-up of fibrous and fatty material inside the arteries (atherosclerosis). Atherosclerosis is the underlying condition that causes heart disease such as heart attacks and strokes as well as affecting the arteries that supply the legs. This is called peripheral arterial disease.

You can read more about peripheral arterial disease on NHS Choices and on the British Heart Foundation website.

Diabetes

Peripheral arterial disease is a known complication of diabetes. You can read more about peripheral arterial disease and diabetes on NHS Choices and on the Diabetes UK website.

Diabetes can also cause loss of sensation (neuropathy) so you may not notice when you injure your foot because you cannot feel the pain.

What do foot ulcers look like?

a image of heel cracks or a potential foot ulcers or sore, after knock - Legs Matter — Examples of heel cracks and the beginnings of a foot ulcer.

Getting diagnosed with a foot ulcer

If you have a wound on your foot that is not healing, make an appointment at your GP practice or with a podiatrist. You may be given an appointment to see the nurse rather than the doctor as they (and podiatrists) are often responsible for caring for patients with leg and foot problems.

If you know you have diabetes and you have a wound on your foot, then you should seek advice from your healthcare professional urgently (i.e. within 1 day).

Make sure you remove any nail polish from your toenails before your appointment.

When you see the nurse, podiatrist or doctor, they should:

Ask about your symptoms and how long you have had problems
Examine your lower legs
Do a special test called a Doppler Ultrasound. This test compares blood flow in your ankle with that in your arm to find out if there are blood flow problems in your lower leg. You may have to come back to have your Doppler test on another day or at another clinic but you should have this test within a few weeks of your first appointment
Test how much sensation you have in your feet

You might also be offered some more tests to rule out other health problems that can affect your legs, including diabetes, anaemia, thyroid, kidney and cholesterol problems.

If your GP practice thinks you have problems with your arteries, they may refer you for further vascular tests at your local hospital or specialist clinic.