Condition Articles-Diabetic Ulcer PDF

Diabetic Ulcer PDF

Pdf Summary

Diabetic ulcers are a common complication in diabetic patients and can occur in up to 12% of the diabetic population. Neuropathy, or the loss of protective sensation, is a key factor in the development of diabetic ulcers. Autonomic dysfunction also occurs, leading to dry cracked skin that is more susceptible to breakdown. Bony prominences can increase shear stress and repetitive trauma can lead to tissue inflammation, necrosis, and ulceration. The clinical presentation of a diabetic ulcer can vary, with some patients presenting with a blister that hasn't resolved and others presenting with deep soft tissue infection or osteomyelitis. A complete neurovascular exam is necessary to assess the ulcer, including its location, depth, undermining, and appearance of underlying tissue. Classification systems such as the Wagner Classification and Brodsky Depth - Ischemia Classification are used to determine the severity of the ulcer. Imaging studies, such as plain radiographs and MRI, may be used to assess bony deformities and evaluate osteomyelitis. Non-invasive vascular studies are also important to assess vascularity and healing potential. Prevention is a key focus in diabetic patients with peripheral neuropathy, including proper foot care, daily foot checks, and using custom total contact inserts and extra depth shoes. Treatment of diabetic ulcers varies depending on factors such as infection and severity, but may include debridement, offloading, total contact casting, and frequent in-office debridements. Surgical options, such as reconstruction or amputation, may be considered in certain cases. Proper and prompt treatment is important in resolving and preventing recurrence of diabetic ulcers.

Keywords

diabetic ulcers

neuropathy

autonomic dysfunction

bony prominences

tissue inflammation

ulceration

Wagner Classification

osteomyelitis

prevention

treatment