Treatment Consists of good diabetic control and ulcers must be treated early and aggressively to prevent progression. Mechanisms that alleviate pressure on the area, such as bedrest and splinting must be employed. Rocker shoes, which spread the pressure more evenly throughout the foot, can be used for ulcers over the metatarsal heads or on the heels. Meticulous skin care, avoidance of trauma, and daily inspections of the foot are all essential. Surgical options for severe cases includes resection of the metatarsal head.
Venous ulcers are a result of chronic venous stasis.
It is believed that a DVT may cause destruction of the venous valves and incomplete recanalization of the thrombosis veins which causes a persistence obstruction in the venous system. All of these factors contribute to a high pressure in the distal veins. The deep venous system becomes subject to the gravitational effects of hydrostatic pressure and capillary and post capillary pressures rise leading to dependent edema. Due to the increased pressure within the capillaries, pressure necrosis results which causes a microextravasation of red cells in the dermal and subdermal tissues. Because of the stasis and backup of blood the foot feels warm and has a strong pulse.