Excessive moisture may promote maceration and decreased tissue tensile strength. Exudate may provide a good medium for bacterial growth. In the absence of a normal cellular immune response, bacterial proliferation may lead to infection. Newer occlusive technologies may allow a dressing to wick excess exudate away from the wound surface and retain it in the dressing, even under pressure. Read package inserts carefully and select products that are appropriate for the patient's needs.
Infection is the most common complication of diabetic ulcers.
Silver sulfadiazine may be effective in reducing bacterial colonization on diabetic ulcers. This treatment should be limited to a maximum of 2 weeks. When applying silver sulfadiazine, place only a thin layer over the wound surface after the wound has been debrided and cleaned. Dressings should be changed every 24 hours. Early detection of infected diabetic foot ulcers may be difficult because neuropathy and cellular abnormalities secondary to diabetes can mask symptoms of pain, erythema, and increased skin temperature.