Saturday, November 29, 2008

Diabetic Blisters

Blisters can be potentially very dangerous in patients who suffer with Diabetes. Normally treatment in a healthy patient would be to lance the blister and leave the flap of skin attached to offer protection to the soft tissue underneath also to apply Tinc Benzoin or other healing agents to speedily heel up the site together with a sterile dressing and follow up appointments. As a preventative measure avoid pressure blister points the use of orthotics/ Padding to help the patient of load pressure that may be causing the problem in the first place.

The problem with Diabetics is this. There is a danger that the blister when lanced in the normal way there may be a high risk of infection of the soft tissue under the blister site, that could ultimately worsen to an ulcer or in the worst case senario develope into gangrene.

Therefore it is with this in mind treating Diabetics with blisters then is most important to treat with care and not to lance the blister, but apply a sterile dressing with the approiate antibiotic and let the blister heal naturally. If there is evidence that the blister has been caused by pressure or shearing forces of the abnormal position of the toes it is adviseable however to apply proper padding to ofload such forces to the area.
Regular visits to the patients must be made to check the area is healing and that there is no danger of infection. 

The blister is filled with a sac of fluid which if left contains anti - bacterial properties and this should prevent infection from occurring. Together with the ofloading at the pressure site this should be sufficient to prevent the blister from bursting the fluid and the blister should disperse into the blood stream and be taken back into the tissue. 
Copyright 2008 Stephen J Kite Bsc Podiatric Medicine 

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