Diabetic Foot Ulcer – Diagnosis and Management

Abstract

Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

Antibiotic therapy for diabetic foot infections in a tertiary care hospital in Jakarta, Indonesia

“…Empirical broad-spectrum antibiotic regimens can be administrated. However, the sensitivity tests of bacterial pathogens should be performed to assist in the selection of appropriate antibiotic treatment regimens [13]. Narrow-spectrum antibiotics can be selected for acute or less severe infection, while the broadspectrum antibiotics should be used in cases of chronic or severe infection [14].…”

A Peep in to Novel Therapies in Diabetic Foot Ulcer

“…Therefore, in the case of hyperglycemia, nitric oxide is disturbed which maintains anticoagulation of the homeostasis, leukocyte adhesion, smooth proliferation of muscle cells and antioxidant capacity. 10…”

The Effect of Modified Diabetes Self-management Education and Support on Self-care and Quality of Life among Patients with Diabetic Foot Ulcers in Rural Area of Indonesia

“…People with diabetes are 15-25% more likely than the general population to develop a foot ulcer [5]. Diabetic foot ulcers (DFUs) cause morbidity and, in some cases, permanent disability in diabetics [6], [7]. Lower extremity ulceration and amputation are associated with an increased risk of death [8], while significant amputation is associated with death [9], [10].…”