Preventing Diabetic Foot Ulcers

Preventing Diabetic Foot Ulcers

Describe briefly diabetic ulcer.

Answer.

Diabetic ulcer is most common in foot. It can cause abscess, ulcer, osteomyelitis, gangrene, septicemia.

“Early Signs Of Diabetic Foot Problems”

Initially, patient undergo toe amputation but later eventually land with below-knee or above-knee amputation.

Diabetic Ulcer Causes

• Increased glucose in the tissue precipitates infection.
• Diabetic microangiopathy which affects microcirculation.
• Increased glycosylated hemoglobin decreases the oxygen dissociation.
• Increased glycosylated tissue protein decreases the oxygen utilization.
• Diabetic neuropathy involving all sensory, motor and autonomous components.
• Associated atherosclerosis.

“Symptoms Of Diabetic Foot Ulcers”

Diabetic Ulcer Sites

• Foot-plantar aspect is the most common site
• Leg
• Upper limb, back, scrotum, perineum
• Diabetic ulcer may be associated with ischemia
• Ulcer is usually spreading and deep

“Understanding The Causes Of Diabetic Foot Ulcers”

Diabetic Ulcer Investigations

• Blood sugar both random and fasting.
• Urine ketone bodies.
• Discharge for culture and sensitivity.
• X-ray of the part to see osteomyelitis.
• Arterial Doppler of the limb; glycosylated hemoglobin estimation.

“Risk Factors For Diabetic Foot Ulcers”

Diabetic Ulcer Problems with diabetic ulcer

• Neuropathy, in foot clawing of toes, hammer toe (due to intrinsic muscle paralysis)
• Multiple deeper abscesses; osteomyelitis of deeper bones are common.
• Reduced leukocyte function; resistant infection; spreading cellulitis
• Arterial Insufficiency
• Septicemia; diabetic ketoacidosis
• Associated cardiac diseases like ischemic heart disease

“Best Ways To Avoid Diabetic Foot Ulcers”

Diabetic Ulcer Treatment

• Control of diabetes by using insulin.
• Proper antibiotics should be started after culture and sensitivity report
• Nutritional supplements.
• Regular cleaning, debridement, dressing.
• Once granulates, the ulcer is covered with skin graft or flip.
• Revascularization procedure is done by endarterectomy or thrombectomy or balloon angioplasty or arterial bypass graft. But if distal vessels are involved, then success rate is less.
• Toe foot/leg amputation.
• Microcellular rubber (MCR) shoes to prevent injuries; care of foot.