A diabetic foot is the foot that indicates any pathology produced directly from diabetes mellitus or complications of long-term (or "chronic" diabetes mellitus). The presence of some typical diabetic foot pathology such as infection, diabetic foot ulcers and neuropathic osteoarthropathy is called diabetic foot syndrome .
Due to peripheral nerve dysfunction associated with diabetes (diabetic neuropathy), patients have less ability to feel pain. This means that minor injuries may still have not been found for a long time. Diabetics are also at risk of diabetic foot ulcers. Research estimates that the incidence of leg ulcers in the diabetic community is about 15% and can be as high as 25%.
In diabetes, peripheral nerve dysfunction can be combined with peripheral arterial disease (PAD) that causes poor blood circulation to the extremities (diabetic angiopathy). About half of patients with diabetic foot ulcers have an existing PAD.
Where the wound takes a long time to heal, infection can occur and a lower limb amputation may be required. Foot infection is the most common cause of non-traumatic amputation in diabetics.
Video Diabetic foot
Prevention
Prevention of diabetic feet may include optimizing metabolic control (regulating glucose levels); identification and screening of persons at high risk for diabetic foot ulcers; and patient education to promote self-examination and foot care knowledge. Patients will be taught routinely to check their feet for hyperkeratosis, yeast infections, skin lesions and foot deformities. Footwear control is also important because recurrent trauma from tight shoes can be a triggering factor. However, there is only limited evidence that patient education has a long-term impact as a precautionary measure.
"Of all the proposed methods for preventing diabetic foot ulcers, only avoiding therapy with foot temperature was found to be beneficial in RCT" according to a meta-analysis.
Maps Diabetic foot
Treatment
Diabetic foot care can be challenging and prolonged; it may include orthopedic equipment, antimicrobial drugs and topical dressings.
Most diabetic foot infections (DFI) require treatment with systemic antibiotics. The choice of initial antibiotic treatment depends on several factors such as the severity of the infection, whether the patient has received other antibiotic treatment for it, and whether the infection has been caused by micro-organisms that are known to be resistant to common diseases. antibiotics (eg MRSA). The goal of antibiotic therapy is to stop the infection and ensure the infection does not spread.
It is not clear whether certain antibiotics are better than other antibiotics to cure the infection or avoid amputation. One experiment suggested that ertapenem with or without vancomycin was more effective than tigecycline to complete DFI. It is generally not clear if different antibiotics are associated with more or fewer side effects.
However it is recommended that antibiotics used for the treatment of diabetic foot ulcers should be used after deep tissue culture of the wound. Tissue culture and not pussy bud should be done. Antibiotics should be used at appropriate doses to prevent the emergence of drug resistance.
References
External links
- MedlinePlus: Diabetic Foot
Source of the article : Wikipedia
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