Diabetic
foot ulcer
Diabetic patients are more prone for development of
ulcers in the foot because of the following reasons (a) it produces neuropathy which manifests after 10 years of
diabetes. Loss of vibration sense and deep tendon reflexes occur early, later joint position, touch, pain and temperature sensations are lost. Clawing of the toes results due to paralysis of intrinsic muscles of foot (b) resistance to
infection is also lowered due to diabetes. Phagocytic activity of leucocytes is greatly reduced (c) diabetes is usually associated with atherosclerosis involving major vessels resulting in ischemia of foot.
Treatment is mainly based on (a)
control of diabetes (b) control of infection (c) treatment of ulcer (d) Various surgeries and (e) Care of patient as a whole
Diabetes should be controlled with insulin rather than oral hypoglycemic drugs. Antibiotics covering both aerobic and anaerobic organisms need to be given. Non healing ulcers need to be treated with debridement and split skin grafting. Sometimes even amputation has to be done.
Lastly “Prevention is always better than cure” Strict glycemic control, regular exercises, healthy habits, MICROCELLULAR rubber shoes which are not only soft but also allow oxygenation need to be used. Keep foot dry after proper cleaning helps to prevent this.
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