Etiology, pathophysiology, diagnosis and management of diabetics’ foot ulcer

Abstract

Diabetic foot ulcers (DFU) is a lesion of all layers of skin, necrosis or gangrene that occurs in the soles of the feet in diabetes mellitus (DM) patients, caused by: (1) causative factor (peripheral neuropathy, high foot plantar pressure and trauma); (2) contributive factors (atherosclerosis and diabetes). The treatments of diabetic ulcers consist of determining and repairing the underlying cause of ulcer, good wound care and prevention of ulcer recurrence. The cause of diabetic ulcers can be determined by deep anamnesis and physical examination. DFU therapy includes necrotomy/debridement, reducing the load/pressure on the offensive area, manage the infection by diagnosing the type of bacteria, providing adequate antibiotics and ulcer treatment using wound dressing clean and moist.

A comparative study on the efficacy of platelet rich plasma vs conventional wound dressing in diabetic foot ulcers

“…Previous studies such as Iraj et al and Rosyid et al also recognize this risk. 22,23 The finding that 78% of the study subjects were on injectable insulin is predictable as the duration of diabetes is directly linked to use of insulin and the risk of DFU.…”

Diabetic Foot Infection, Biofilm & New Management Strategy

“…Incidences of DFU continue to increase worldwide [8]. The prevalence of DFU is not accurately known and the difference in prevalence rates in each country is estimated at 4-27% of DFU sufferers worldwide [9]. The lifetime risk of foot ulcers until recently was generally believed to be 15-25%; however, recent data suggest that the figure may be as high as 34% [10].…”

“…The lifetime risk of foot ulcers until recently was generally believed to be 15-25%; however, recent data suggest that the figure may be as high as 34% [10]. Studies have shown that 15% of patients with DM will experience complications of DFU in the future [9].…”

“…Diabetes UK reports 23 legs are being amputated daily in the NHS system [12]. The prevalence of diabetic ulcer patients in the United States is 15-20% & the risk of amputation is 15-46% more compared with non-DM patients [9].…”

“…Major amputation is associated with significant morbidity and mortality (ranging from 13 to 40% at 1 year to 39 to 80% at 5 years) in addition to immense social, psychological, and financial consequences [2]. [2,9] In DM, patients are characterized by high blood glucose levels which results in endothelial dysfunction, mitochondrial dysfunction, cellular nerve damage, microvasculature damage & also impaired myelin regeneration. DFUs result from interaction between two major risk factors: neuropathy and peripheral vascular disease.…”