Healing ulcers and preventing their recurrences in the diabetic foot

S Raja Sabapathy, Periasamy MadhuIndian Journal of Plastic Surgery 2016 49(3):302-313Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers. Ulcer management must not only address the healing of ulcers but also should correct the altered bio-mechanics to reduce the focal pressure points and prevent recurrence. An analysis of 700 patients presenting with foot problems to the Diabetic Clinic of Ganga Hospital led to the stratification of these patients into four classes of incremental severity. Class 1 – the foot at risk, Class 2 – superficial ulcers without infection, Class 3 – the crippled foot and Class 4 – the critical foot. Almost 77.5% presented in either Class 3 or 4 with complicated foot ulcers requiring major reconstruction or amputation. Class 1 foot can be managed conservatively with foot care and appropriate foot wear. Class 2 in addition to measures for ulcer healing would need surg...
Source: Indian Journal of Plastic Surgery - Category: Cosmetic Surgery Authors: Source Type: research

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AbstractIntroductionDiabetic foot ulcers develop with deviations in the distribution of plantar pressure. It is difficult to interpret any alteration in plantar pressure under different conditions of type 2 diabetes mellitus (T2DM). The aim of this study was to gain a better insight into the variations in plantar pressure with increased duration of diabetes.MethodsPlantar pressure was examined in 1196 participants with or without T2DM. Subjects with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) were assigned to control groups, and those with T2DM were divided into five groups according to diabetes dur...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
I, Cauli O Abstract Diabetic foot syndrome (DFS) is a common long-term complication of diabetes mellitus. DFS has recently been associated with adverse effects in brain function which could further impair the quality of life of these patients, as well as increase the social and economic burden, morbidity, and premature mortality of the disease. The current knowledge of neuropsychiatric alterations e.g. cognitive impairment, gait disorder, depression, and quality of life in patients with diabetic foot syndrome is summarized. The cognitive domains altered in DFS are executive function, memory, and psychomotor speed...
Source: CNS and Neurological Disorders Drug Targets - Category: Drugs & Pharmacology Authors: Tags: CNS Neurol Disord Drug Targets Source Type: research
ConclusionCholerae should be included in the differential diagnosis of any bacteremic skin and soft tissue infections especially in elderly, comorbid and immune-compromised patients. Well-timed, proper antibiotic and surgical treatments are important in management of the infection to decrease morbidity and mortality.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionSeverely anemic patients in critical condition can survive necrotizing fasciitis with a well-planned interdisciplinary approach without compromising patient autonomy.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONS: Although both metformin and BM-MSCs were effective in the healing of experimentally induced skin wounds in diabetic rats, the combination of both agents appears to be a better synergistic option for the treatment of diabetic wound injuries. PMID: 31489604 [PubMed - as supplied by publisher]
Source: Folia Histochemica et Cytobiologica - Category: Cytology Tags: Folia Histochem Cytobiol Source Type: research
CONCLUSIONSeverely anemic patients in critical condition can survive necrotizing fasciitis with a well-planned interdisciplinary approach without compromising patient autonomy.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONS: These results showed length of surgery and intraoperative blood loss were independent risk factors for PU after liver resection with a long surgical duration. Use of PU prevention strategies are recommended for patients who undergo liver resection with massive intraoperative blood loss and long surgical duration. PMID: 31461399 [PubMed - in process]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
Purpose of review The current review addresses one of the most common neurological disorders, diabetic polyneuropathy (DPN). DPN is debilitating, irreversible and dwarfs the prevalence of most other chronic disorders of the nervous system. Its complications include foot ulceration, amputation, falling and intractable neuropathic pain. Moreover, tight control of hyperglycemia reduces the incidence of DPN in type 1 diabetes mellitus but its role in type 2 diabetes mellitus is less clear. Recent findings New therapeutic options to reverse the development of DPN or its associated pain have been proposed but none have sign...
Source: Current Opinion in Neurology - Category: Neurology Tags: PERIPHERAL NERVE AND NEURO-MUSCULAR JUNCTION DISEASE: Edited by Mary M. Reilly Source Type: research
This study addresses principal aspects in the prevention of DFUs. First, the sensor-equipped insole will be evaluated for daily performance in home-based measurements of foot temperatures. Second, a telemedicine structure is tested that evaluates sensor data automatically and proposes suitable intervention measures under the supervision of a physician. Third, predictive models for DFUs will be built using the collected sensor data allowing for interpretations, which in the future may support medical care providers.Trial registrationGerman Clinical Trials Register (DRKS),DRKS00013798. Registered on 18 January 2018.
Source: Trials - Category: Research Source Type: clinical trials
Introduction: Necrolytic migratory erythema (NME) may correspond to a paraneoplastic syndrome. It usually occurs in patients with glucagonoma, an alpha cell pancreatic tumor. When associated with weight loss, angular stomatitis, glossitis, diabetes mellitus, anemia and neuropsychiatric disorders defines the glucagonoma syndrome. NME lesions present as erythematous maculopapules with blisters and ulceration, occurring mostly on perineum, lower abdomen, extremities and face.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
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