Why do wounds heal more slowly? How can this be prevented?  

Ever fall and scrape your foot or get a splinter in your toe? For most of us, these minor wounds heal quickly. But people with diabetes – who number about 30 million in the United States, according to the Centers for Disease Control and Prevention – face higher odds that their wounds will heal slowly or not at all, leading to potentially dangerous complications.

About 28 percent of patients who come to the three Inova Wound Healing Centers are diabetics with foot wounds, according to David Charash, DO, Medical Director of Wound Care. His multidisciplinary team stands ready with a variety of treatment approaches to tackle stubborn wounds, including state-of-the-art skin substitutes and oxygen-infusing hyperbaric therapy.

“One of the side effects of diabetes is neuropathy, or decreased sensation, so diabetics are more prone to getting a wound in their feet or lower legs,” Dr. Charash explains. “And because they don’t feel it, it has a chance to get infected. It’s a very common problem in people with diabetes.”

Feet First

Neuropathy is just one of the factors influencing wound development and poor healing in these patients, Dr. Charash says. Driven by high blood sugar levels, diabetes can also damage blood vessels, hindering the flow of healing, oxygen-rich blood. Smoking can make this problem worse.

“If a patient’s shoes aren’t fitting properly, blisters can form from friction. If they stub their toe and don’t feel it, it can create a wound,” Dr. Charash says. “Certain medications can also inhibit wound healing, such as some cancer drugs or steroids. Hundreds of variables can help us predict a good wound healer vs. a poor wound healer.”

The consequences of poor wound healing can be dire. According to the American Podiatric Medical Association, diabetes is the top cause of nontraumatic foot or lower leg amputations in the United States. A diabetes patient who undergoes amputation of one lower limb faces a 50 percent chance of requiring an amputation on the other side within five years, Dr. Charash says. “Those with two amputations in a five- to 10-year period have a 50 percent mortality rate,” he adds.

Tips for Healing and Prevention

Given the risks of diabetes-related foot wounds, how can patients help heal them? They may need to “off-load,” or remove the pressure from the wound on the affected foot. Your wound care provider will establish a plan which will optimize wound healing.

Preventing wounds from developing in the first place is the ideal, of course. To that end, people with diabetes should aim for healthy lifestyle choices, optimization of their diabetes and getting diabetic education. A daily foot self-examination is a good way to detect the presence of a wound.

“Avoid walking barefoot, and seek evaluation by a medical provider promptly if a wound appears,” Dr. Charash adds. “Early intervention is key.”


The Inova Wound Healing Centers offer the area’s largest, most experienced team dedicated to treating difficult-to-heal wounds. Visit our website to learn more about all of Inova’s wound healing locations (Mount Vernon, Fair Oaks, and Fairfax/Woodburn). You can also call us at 703-664-8020.

RELATED: Inova Mount Vernon’s individualized care helps heal chronic and non-healing wounds

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