Prevention and Treatment of Ulcerations of the Foot in Unilaterally Amputated Diabetic Patients

Larsen, Kirsten; Christiansen, Jens Sandahl; Ebskov, B

doi:10.3109/17453678208992245

Cited by 14 publications

(4 citation statements)

References 9 publications

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“…It is essential that these individuals be screened for the presence of DN, because of the known efficacy of therapeutic interventions (10,11). Initial treatment strategies in DN consist of rigorous foot care and good glucose control (27)(28)(29)(30)(31)(32). The DCCT provides direct evidence that optimal glucose control can decrease DN with a reported 60% reduction in the incidence of DN in the combined primary-and secondary-prevention cohorts (10).…”

Section: Dnsmentioning

confidence: 99%

A Multicenter Study on the Prevalence of Diabetic Neuropathy in Italy

et al. 1997

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Section: Dnsmentioning

confidence: 99%

A Multicenter Study on the Prevalence of Diabetic Neuropathy in Italy

et al. 1997

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“…Eighteen patients (7%) had ulcers on the tip of the big toe, in one case on both feet, caused by abnormal functional extension. The patients were supplied with insoles made from soft materials using functional imprints (Holstein et al, 1976;Larsen et al, 1982). In 13 patientsflexor pads were placed underneath the big toes.…”

Section: Methodsmentioning

confidence: 99%

Abnormal extension of the big toe as a cause of ulceration in diabetic feet

Larsen¹,

Holstein²

1987

Prosthetics &Amp; Orthotics International

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Relief from external pressure and repetitive stress is a main concept in treating diabetic neuropathic ulcers. Ulcers on the tip of the big toe may be caused by abnormal extension of the big toe, which can be diagnosed only by observing the patient during barefoot walking. A flexor pad underneath the big toe eliminates the phenomenon, bul in case of rigidity of the toe, extremely roomy toe boxes must be prescribed. Out of a series of 272 diabetic patients with skin lesions on the feet 18 suffered this phenomenon, in one case with bilateral ulcerations. Fifteen ulcers healed and below the knee amputation had to be carried out in 4 legs due to ischaemia.

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“…Recent studies, however, suggest that the progressive destruction of the neuropathic or gangrenous foot can be stopped and the number of amputations substantially decreased (Holstein et al, 1976;Wagner, 1979;Brand, 1979;Lippmann, 1979;Runyan et a1 All corres ondence to be addressed to Ms. K. Larsen, Rollelevbakken 14,DK 2830Virum, Denmark. 1980Larsen et al, 1982;Pollard and Le Quesne, 1983;Burden et al, 1983). The present study was undertaken to evaluate healing results and to identify high risk patients as regards recurrent ulceration and risk of amputation.…”

Section: Introductionmentioning

confidence: 99%

Limb salvage in diabetics with foot ulcers

Larsen¹,

Holstein²,

Deckert³

1989

Prosthetics &Amp; Orthotics International

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The healing results in 491 ulcers in 272 diabetic patients are reported. Soft moulded insoles and shoe corrections were the main part of the therapy. There were 329 (67%) neuropathic, 87 (17%) traumatic, 44 (9%) ischaemic and 31 (6%) ulcers of other various pathogenesis. Thirty seven per cent of the ulcers were complicated with invasive infection. Within the period of observation of 18 months (3-39 months) healing was obtained in 79% of the patients (88% of the ulcers) and major amputation was carried out in 8% (4% of the ulcers). There were 21 major amputations, which in 18 cases was due to ischaemia. Thus in only 3 cases (1% of the patients) neuropathy as complicated by invasive infection caused major amputation. Fifty nine ulcers (12%) were classified as relapsing ulcers or ulcers with new localizations and were caused by severe deformity of the foot (58 cases) often in combination with neglect of prophylaxis (7 cases). Only one recurrent ulcer was caused by ischaemia. The series shows that shoe corrections and insoles are effective in treating diabetic neuropathic ulcers. Recurrent ulcerations are caused by severe foot deformity and neglect of therapy. Loss of limbs is caused by ischaemia and invasive infection.

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Prevention and Treatment of Ulcerations of the Foot in Unilaterally Amputated Diabetic Patients

Cited by 14 publications

References 9 publications

A Multicenter Study on the Prevalence of Diabetic Neuropathy in Italy

A Multicenter Study on the Prevalence of Diabetic Neuropathy in Italy

Abnormal extension of the big toe as a cause of ulceration in diabetic feet

Limb salvage in diabetics with foot ulcers

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