Should a diabetic foot ulcer be kept moist?

Moist on the wound, dry around it. A dressing keeps the wound moist, which promotes healing, but keep the dressing and the skin around the ulcer dry, because healthy tissue that gets too wet can soften and cause more foot problems.

Yes for the wound, and no for the skin around it. The whole answer is in keeping those two apart.

On the wound. At a wound care center, after the wound is clean your provider will apply a dressing to keep the wound moist, which promotes healing, and help prevent infection. The same goes for pressure sores: a dressing protects against infection and helps keep the sore moist so it can heal.

On the skin around it. The other direction is just as important: keep your dressing and the skin around it dry. Try not to get healthy tissue around your ulcer too wet from your dressings. This can soften the healthy tissue and cause more foot problems.

Wound bed moist. Surrounding skin dry. Those are not in conflict; they are instructions about two different surfaces. Reading them as one contradictory rule is the most common way to get this wrong.

There is a point of tension worth naming honestly. One of the dressings often used first for a diabetic foot ulcer is a wet-to-dry dressing. It is applied wet and allowed to dry so that it lifts wound material off as it is removed. That is not a moisture-retaining dressing. Which approach suits a particular ulcer is a clinical decision.

Everything else stays the same: keep the ulcer clean and bandaged, cleanse the wound daily, and follow the dressing routine you were given.

What to watch for

Keep the dressing and the skin around the ulcer dry. Healthy tissue that gets too wet can soften and cause more foot problems. Skin around the ulcer that looks white and soft is a reason to have the routine reviewed.

A dressing is applied to keep the wound moist, which promotes healing, and to help prevent infection.

Follow the dressing routine you were given. If it is not clear whether your dressing is meant to stay moist, that is a question for the person who chose it.

Signs of infection to contact a provider about: redness, increased warmth, or swelling around the wound; extra drainage; pus; odor; fever or chills; increased pain; increased firmness around the wound.

Wound Wizard is general education and cannot assess your ulcer. Your own clinician is the right person to ask.

What we look at

  • Examining the wound bed and the skin around it
  • Choosing a dressing and a change frequency
  • Checking whether the surrounding skin is being damaged
  • Adjusting the routine if the skin is softening

Sources

  1. Diabetes - foot ulcers — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000077.htm
  2. Wound care centers — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000739.htm
  3. How to care for pressure sores — MedlinePlus, U.S. National Library of Medicine https://www.medlineplus.gov/ency/patientinstructions/000740.htm