DFU Manual - Episode 6 - I Have a Wound — Now What

Session 6 of the Diabetic Foot Manual centers on Pedro, 56, who has lived with diabetes for twelve years and ignored a foot wound for a month — now it smells. His case anchors the rule that governs this episode: any wound below the ankle in a person with diabetes is a diabetic foot ulcer, regardless of size, appearance, or pain. ### Why small wounds are never small A painless cut on the sole can hide deep tissue damage and infection tracking toward bone. Without urgent care, the infection spreads, tissue dies, and amputation becomes the outcome. What looks minor on the surface is often already serious underneath — Pedro's odor is a late warning sign. ### What Pedro must do, and must not do 1. Go to the nearest health center the same day, no matter how the wound looks. 2. Do not cover it with plants, leaves, sugar, honey, toothpaste, oils, or iodine — home remedies delay care and mask infection. 3. If hospitalization isn't needed, see a nutritionist, follow medication instructions strictly, and use insulin exactly as prescribed. 4. Stop smoking and drinking alcohol — smoking sharply raises amputation risk. 5. Ask about an offloading shoe to take pressure off the wound while it heals. Pedro's four lessons: below the ankle counts, no exceptions; small wounds hide big damage; skip the home remedies; and stay on your medication. This session's content comes from Alianza Para El Salvataje del Pie Diabético in Peru, brought to you by Pingoo, the between-visit wound care companion. For clinicians managing these patients, see our approach to diabetic foot care. Next up in Session 7: how to clean, cover, and protect a wound at home between visits.