In a skin graft, a piece of skin is surgically removed from a healthy part of the body and used to cover the wound. Skin grafts on the soles of the feet can be problematic, however, because unless the cause of the wound is corrected the wound can return. For example, if the wound is caused by an abnormal bony prominence in the foot, padding the area will be necessary to prevent the wound from recurring. For the diabetic, an infected wound should be treated as an emergency. Signs of infection include pus oozing from a wound, redness, swelling or fever, excessive sugar in the urine, and blood sugar that is difficult to control or which requires a higher than normal dosage of insulin.
Infection typically requires treatment with antibiotics.
However, this too can be problematic for diabetics, because antibiotics work within the bloodstream, and the circulatory difficulties experienced by most diabetes patients make it hard for antibiotics to reach an infected area. Swelling in the area of an infection also can constrict blood vessels and arteries, further diminishing circulation. Thorough cleaning of a wound or open sore usually is necessary, and in serious cases hospitalization and surgical treatment may be required to improve circulation to the injured area. This usually must be followed by a lengthy period of recuperation. If surgery involves a foot or leg, the patient typically must keep weight off the affected leg afterward, necessitating the use of crutches, a wheelchair or a specially designed full contact cast.