Aissar Shawaqfeh Registered Nurse · Certified Wound Specialist (CWS®) العربية

Diabetic foot wounds: prevention and care

A small wound on the foot of a person with diabetes can deteriorate quickly if it is not found and treated early. This page explains why, the warning signs to act on, and how to protect your feet every day.

Written by: Aissar Shawaqfeh, RN, CWS® Last reviewed: Credentials and verification

This information is general education and does not replace an individual medical assessment. Do not change your treatment or dressings without speaking to your care team.

Why are diabetic foot wounds serious?

The risk comes from several factors that often occur together:

  • Reduced sensation (neuropathy): a stone in the shoe, a burn or a cut may not be felt.
  • Reduced blood supply to the legs and feet, which slows healing.
  • Changes in foot shape and pressure points, leading to cracks or calluses that can become ulcers.
  • Lower resistance to infection when blood glucose is high.

This is why international guidelines recommend that any wound on the foot of a person with diabetes is assessed promptly and not left to home treatment alone.

Daily foot check for people with diabetes: look at these areas, using a mirror if needed. Toe tips Between the toes Ball of the foot Side of the foot Heel
Daily foot check for people with diabetes: look at these areas, using a mirror if needed.

Warning signs that need urgent medical review

See a doctor the same day, or go to the emergency department, if a person with diabetes has:

  • Any new wound or ulcer on the foot, even if it looks small or is painless.
  • Redness, warmth or swelling in the foot, especially if it is spreading.
  • Pus or a bad smell from a wound.
  • Toes turning blue or black, or a foot that is cold and pale.
  • Fever, chills, or unusually high blood glucose together with a foot wound.

Everyday habits that protect the feet

  • Check your feet every day, including between the toes and the soles. Use a mirror or ask for help.
  • Never walk barefoot, indoors or outdoors.
  • Wear comfortable, well-fitting shoes, and check inside them before putting them on.
  • Wash and dry your feet well, especially between the toes. Moisturise dry skin, but not between the toes.
  • Don’t cut corns or hard skin yourself, and don’t use corn plasters.
  • Cut toenails straight across, and ask for help if your eyesight or mobility is limited.
  • Don’t warm your feet with hot water or directly at a heater, because burns may not be felt.
  • Keep blood glucose well controlled and have your feet checked regularly.

How is a diabetic foot wound cared for?

Caring for a diabetic foot wound is a team effort. It usually includes:

  • Offloading pressure from the wound with special footwear or devices chosen by the treating team, which is one of the most important factors in healing.
  • Assessing blood supply, with referral to a vascular surgeon when needed.
  • Treating infection, as decided by the doctor. Some cases need hospital admission.
  • Removing dead tissue and callus around the wound, done by a trained professional.
  • Choosing dressings to suit the wound, with regular follow-up and measurement of progress.
  • Blood glucose control, coordinated with the treating doctor.

The specialist nurse contributes assessment, wound care and patient education within the plan set by the physician and the multidisciplinary team.

After the wound heals

The risk of an ulcer coming back is high after healing. Daily foot checks, suitable footwear and regular follow-up with the care team continue even after the wound has closed.

Common mistakes to avoid

  • Waiting for the wound to heal on its own, because reduced sensation can make it painless and seem minor.
  • Walking on the wound and not following the offloading plan set by the team.
  • Home remedies such as coffee, toothpaste, herbs or unprescribed creams.
  • Soaking the foot for long periods or in hot water.
  • Cutting corns or hard skin with blades, or using corn plasters.
  • Neglecting blood glucose control, or stopping follow-up after healing.

Educational videos

Watch the educational videosShort wound-care explainers on Instagram

A multidisciplinary team

A complex wound is never treated by one specialty alone. Care is coordinated with a multidisciplinary team according to each case, because healing depends on treating the cause: circulation, infection, pressure, nutrition and the need for surgery.

  • Orthopaedic surgery
  • Vascular surgery
  • General surgery
  • Plastic and reconstructive surgery
  • Podiatry
  • Infectious diseases
  • Clinical nutrition
  • Other healthcare professionals as each case requires

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For patients and families: discuss any change to your care plan with your treating doctor or care team.

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Frequently asked questions

Who treats a diabetic foot wound in Jordan?

A diabetic foot wound is usually managed by a multidisciplinary team: the treating physician or an endocrinologist for blood glucose control, a vascular surgeon to assess blood flow, an orthopaedic surgeon or podiatrist for foot deformity and offloading, an infectious diseases specialist when there is infection, a clinical nutritionist, and a nurse or certified wound specialist for regular wound care and patient and family education.

What does a Certified Wound Specialist (CWS®) do for a diabetic foot wound?

A certified wound specialist assesses and measures the wound, documents progress, chooses dressings to suit the wound, supports the offloading plan, teaches patients and families daily foot checks, and alerts the physician early to signs of infection or poor blood flow. Diagnosis, prescribing and surgical decisions remain with the physician.

When does a diabetic foot wound need urgent review?

Any new wound on the foot of a person with diabetes should be seen by a doctor the same day. Go to the emergency department straight away if there is spreading redness, swelling, pus, a bad smell, fever, or toes turning blue or black.

Can a diabetic foot wound be cared for at home?

Daily care such as dressing changes and foot checks often happens at home, but only under a plan set by the treating team after a medical assessment, with regular follow-up. A diabetic foot wound should never be left to home treatment alone.

References

  1. Schaper NC, van Netten JJ, Apelqvist J, et al. Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update). Diabetes/Metabolism Research and Reviews. 2024;40(3):e3657.
  2. International Working Group on the Diabetic Foot (IWGDF). Guidelines on the prevention and management of diabetes-related foot disease.
  3. International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. International Consensus Update 2022. Wounds International.
  4. Conte MS, Bradbury AW, Kolh P, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. Journal of Vascular Surgery. 2019;69(6S):3S–125S.

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