Diabetic foot syndrome

Overview

A diabetic foot ulcer appears in 15-20 % of diabetics in their lifetime. It is a very frequent, but often neglected problem. The aetiology of a diabetic ulcer is particularly associated with neuropathy and ischaemia of the lower limb, most often induced by a trauma. Infectious complication prolongs or arrests the healing process, significantly increasing the risk of amputation. Charcot arthropathy very often leads to the foot ulcer, it is one of the consequences of neuropathy. Early diagnosis and treatment of Charcot arthropathy in the acute phase of disease may prevent deformity and its complications. The risk of diabetic foot syndrome increases with age, comorbidities, and duration of diabetes. Complex therapy of diabetic foot syndrome includes treatment of all risk factors such as ischaemia, infection, pressure on ulceration, metabolic compensation. Local therapy implies debridement (necrectomy), using a new local treatment, which encourages granulation and epithelisation, and then protecting the newly created scar against trauma. Surgical treatment represents an important role in the therapy. There are a host of surgical procedures – preventive operations, effective debridement, and resecting infected bone. The most important is essential amputation in indicated cases. There is a tendency to minimize amputations and protect the structure and the function of the foot. Primary prevention of diabetic ulcers and secondary prevention of reulceration play key roles in reducing the number of patients with diabetic foot syndrome.

Key words:
diabetic foot syndrome, diabetic ulcers