Practical Approach To Diabetic Foot



Foot ulceration is a dreaded complication of diabetes that often results in diminished quality of life. By ‘A rule of 15’ 15% of people develop an ulcer, 15% of ulcers will develop osteomyelitis and 15% ulcers result in amputation. 85% amputations result from non-healing ulcer. Approximately half of amputated patients will have contralateral amputations within 3 years and half will die within 5 years.
Every break in the skin in diabetic foot is a portal of entry for bacteria and has the potential for disaster. Many patients go for amputation following a trivial lesion. A diabetic foot lesion should never be considered as trivial until it is healed and has remained healed for at least a month.
The underlying cause of diabetic foot ulcer will have a signi cant bearing on the clinical management and must be determined before care plan is put into place. So in most patients peripheral neuropathy and peripheral arterial disease play a central role. The diabetic foot ulcers are commonly classif ed as 1. Neuropathic, 2. Ischaemic, 3. neuro ischaemic.
Neuro ischemia is a combined e ect of diabetic neuropathy and ischaemia. Where by macro vascular disease and in some instances micro vascular dysfunction, impair perfusion in a diabetic foot.