Diabetic foot ulcer

Diabetic foot ulcer
Neuropathic diabetic foot ulcer
Classification and external resources
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Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot.

Wound healing is an innate mechanism of action that works reliably most of the time. A key feature of wound healing is stepwise repair of lost extracellular matrix (ECM) that forms the largest component of the dermal skin layer. But in some cases, certain disorders or physiological insult disturbs the wound healing process. Diabetes mellitus is one such metabolic disorder that impedes the normal steps of the wound healing process. Many studies show a prolonged inflammatory phase in diabetic wounds, which causes a delay in the formation of mature granulation tissue and a parallel reduction in wound tensile strength.

Treatment of diabetic foot ulcers should include: blood sugar control, removing dead tissue from the wound, dressings, and removing pressure from the wound through techniques such as total contact casting. Surgery in some cases may improve outcomes.Hyperbaric oxygen therapy may also help but is expensive.

It occurs in 15% of people with diabetes and precedes 84% of all diabetes-related lower-leg amputations.

Risk factors implicated in the development of diabetic foot ulcers are infection, older age,diabetic neuropathy, peripheral vascular disease, cigarette smoking, poor glycemic control, previous foot ulcerations or amputations, diabetic nephropathy, and ischemia of small and large blood vessels. Prior history of foot  disease, foot deformities that produce abnormally high forces of pressure,  renal  failure, oedema, impaired ability to look after personal care are further risk factors for diabetic foot ulcer.

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