How do I know if the wound on my foot is infected?

Diabetic foot ulcers are often painless, so don’t wait for pain. Contact your provider for redness, increased warmth or swelling around the wound, extra drainage, pus, odor, fever or chills, increased pain, increased firmness, or an ulcer that is very white, blue or black.

On a foot, the usual first warning sign can be missing. Diabetic ulcers are often painless, because of decreased feeling in the feet. If pain is the sign you are waiting for, you may wait a long time. You have to check by eye and by hand instead.

For a foot ulcer, contact your provider if you have any of these signs of infection: redness, increased warmth, or swelling around the wound; extra drainage; pus; odor; fever or chills; increased pain; or increased firmness around the wound.

Increased firmness is the one most often missed, because you feel it rather than see it. Pressing gently around the wound, and comparing with yesterday, is a different check from looking at it.

Color is a separate warning. Also contact your provider if your foot ulcer is very white, blue, or black. That is a reason to make contact whether or not any sign of infection is present.

Foot wounds are taken this seriously for a reason. Diabetes can damage the nerves and blood vessels in your feet. As a result, your feet are more likely to get injured and may not heal well if they are injured. Foot ulcers are a common reason for hospital stays for people with diabetes. That is why a new sign on a foot wound is worth a phone call rather than a wait.

What to watch for

Contact your provider if you have any of these signs of infection with a foot ulcer: redness, increased warmth, or swelling around the wound; extra drainage; pus; odor; fever or chills; increased pain; or increased firmness around the wound. Also contact your provider if your foot ulcer is very white, blue, or black.

Because feeling in the foot may be reduced, check on a schedule rather than waiting to notice something. Look at the top and the bottom of the foot and between the toes, and press gently around the wound to compare firmness with the day before. If you find any of these signs, contact your provider. Don’t just watch and see what happens.

What we look at

  • Which infection signs are present, and when each appeared
  • Whether sensation is reduced, so that pain cannot be relied on
  • Whether the ulcer is very white, blue or black
  • Whether firmness around the wound has increased
  • Whether blood sugar control has changed recently

Sources

  1. MedlinePlus — Diabetes, foot ulcers: https://medlineplus.gov/ency/patientinstructions/000077.htm