Case Study 1: Ulcer History
With Mr Bearay's shoes off the student continues the history by examining Mr Bearay's ulcer.
A foot ulcer is an open sore on the foot. They can present as:
- a shallow red break in the skin that involves only the surface of the skin; or
- a deep foot ulcer that may extend through the full thickness of the skin. It may involve tendons, bones and other deep structures.
People with diabetes, like Mr Bearay and people with poor circulation are more likely to develop foot ulcers. These ulcers can be difficult to heal and even a small foot ulcer can become infected if it does not heal quickly.
Show transcript
Student: So Mr Bearay you have already mentioned to me that you previously had an ulcer on one of your feet?
Mr Bearay: yes the left foot
Student: how long ago was that?
Mr Bearay: about a year - I thought it was just hard skin
Lloyd: Foot ulcers are a serious complication of diabetes. We know that
- approximately 7% of the population have type 2 diabetes
- 15% of those will develop a foot ulcer in there lifetime
- foot ulcers can lead to amputation
- in Australia diabetes is the most common cause of non-traumatic lower limb amputation and five year survival is poor with mortality rates ranging from 39 to 80%.
Mr Bearay: the way the foot's been collapsing there is a bone seems to stick down into the foot and I thought it was just hard skin had the skin removed and found an ulcer underneath it
Student: was it infected at all?
Mr Bearay: No, no it seemed fine - once they cleaned all the hard skin away it just needed dressing
Student: You didn't need antibiotics at all?
Mr Bearay: No
Student: That's good - did you have any other imaging done - like an X-ray at all?
Mr Bearay: I have had an X-ray of all of that foot - I have given that to the podiatrist
Student: So how long did it take for your ulcer to heal?
Mr Bearay: It seemed to start to heal quite quickly - but then there was a little relapse they found - I think personally that it was always there of to the side but nobody managed to pick that up and it appeared again and when we got rid of that - it healed since probably about 9 months till that second bit showed up and then its gone now - it was about a year all up
Student: okay and you haven't had another one since?
Mr Bearay: No
Student: Okay great
