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2.1
Diabetic Ulcer
Ulcer Diabetic

Presentation

The objective of the present study was to collect evidence regarding the use of PRP for the topical treatment of chronic leg ulcers. [ncbi.nlm.nih.gov]

Results: Our findings present that neurologic and circulatory assessments were considered as primary steps prior to conducting interventions. [eurekaselect.com]

In this case series we present our clinical experience and management of three patients presenting with a hot swollen foot with associated non healing ulcers. [bjd-abcd.com]

The techniques presented herein are for informational purposes only. [acell.com]

Majority of the cases presented with ulcer within 6–10 years of being diagnosed as a diabetic, whereas 8.2% of cases presented even after 20 years of diagnosis. [cjhr.org]

Entire Body System

  • Nightmare

    From a medicolegal perspective, heel ulcers are a nightmare for hospitals, extended care facilities and providers as the formation of a heel ulcer carries an implication of negligence, abuse or overall poor quality of care. [podiatrytoday.com]

Liver, Gall & Pancreas

  • Protein S Deficiency

    These inherited defects are best remembered by the mnemonic STALL Coagulation and include protein S deficiency, proThrombin mutation, Antithrombin III deficiency, Lupus anticoagulant antibodies, factor V Leiden mutation, and protein C deficiency, in addition [clinicaladvisor.com]

Musculoskeletal

  • Metatarsophalangeal Arthritis

    […] and first metatarsophalangeal arthritis.4,6-8,11,12,17,50-57 Tendon lengthening can help address foot pain and deformity from these conditions.4,6,7,11,14,27,47,50-56 Patients with diabetes have a higher complication rate with foot and ankle surgery.58 [podiatrytoday.com]

  • Ankle Arthritis

    Increased stress in the foot can also cause deformity and foot pain including corns, calluses, clawtoes, plantar fasciitis, posterior tibial tendinitis, arch collapse, foot and ankle arthritis, Charcot arthropathy, Achilles tendinitis, metatarsalgia, [podiatrytoday.com]

Skin

  • Eruptions

    After several known eruptions around 600,000 and 280,000 years ago, its last eruption was around 5300 BC in the Holocene. [vucalu.jecool.net]

    Eruptive-xanthomatosis These bumps appear suddenly and clear promptly when diabetes is well-controlled. When these bumps appear, they often look like pimples. Unlike pimples, they soon develop a yellowish color. [aad.org]

Workup

Because it presents as an open, necrotic ulcer, ruling out infection is a top priority. 3 However, an initial workup to rule out infection or other conditions can delay diagnosis and treatment, 1 and treatment with broad-spectrum antibiotics poses the [mdedge.com]

Plain radiographs are useful in the initial workup of a diabetic foot infection. Particular attention should be paid to any radiographic abnormalities, such as cortical erosions, periosteal reactions, soft tissue gas, or radiopaque foreign bodies. [journals.sagepub.com]

Treatment

Healing of lesions is problematic in some cases using conventional treatment. [ncbi.nlm.nih.gov]

Global Diabetic Ulcers Treatment Market Analysis and Forecast, by Treatment Type 7.1. Introduction & Definition 7.2. Key Findings / Developments 7.3. Global Diabetic Ulcers Treatment Market Value Forecast, by Treatment Type, 2016-2026 7.3.1. [gii.co.jp]

Prognosis

Around 3-15% of all cutaneous melanomas are located on the foot and have a poorer prognosis than melanoma elsewhere. [ncbi.nlm.nih.gov]

The prognosis for people with an infected diabetic foot ulcer is worse than was previously thought, according to new research. [eurekalert.org]

Outlook (Prognosis) Without treatment, this condition can be life threatening. Severe infection is the most frequent cause of death. With treatment, the disorder tends to be chronic. Side effects of treatment may be severe or disabling. [mountsinai.org]

Prognosis Mortality in people with diabetes and foot ulcers is often the result of associated large vessel arteriosclerotic disease involving the coronary or renal arteries. [emedicine.medscape.com]

Etiology

Five of the seven randomized clinical trials studied ulcers of diabetic etiology. The results of meta-analysis showed that PRP favors the healing process (95% CI: 2.94-20.31). [ncbi.nlm.nih.gov]

Etiology “The majority of foot ulcers appear to result from minor trauma in the presence of sensory neuropathy.” [clinical.diabetesjournals.org]

Determining the underlying etiology of the ulcer and ascertaining whether the lesion is neuropathic, ischemic, or induced by adjacent foot deformity is important. [o-wm.com]

Epidemiology

References:[2][48][49][50][51][52][53][21] Diabetic retinopathy Epidemiology After 15 years with disease, approx. 90% of type 1 diabetic patients and approx. 25% of type 2 diabetic patients develop diabetic retinopathy. [amboss.com]

Based on the findings of this study the epidemiological pattern of non-diabetic foot ulceration and its pathogenesis requires further investigation. [jfootankleres.biomedcentral.com]

Epidemiology and health care costs of diabetic foot problems. In: Veves A, Giurini JM, LoGerfo FW, eds. The Diabetic Foot: Medical and Surgical Management. New York, NY: Humana Press; 2002:35-58. Sen CK. [woundcareadvisor.com]

Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA, 301 (2009), pp. 2129-2140 [12] Asociación Latinoamericana de Diabetes. Guías ALAD de Pie Diabético. Revista de la Asociación Latinoamericana de Diabetes, 18 (2010), [13] M.A. [elsevier.es]

The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab Res Rev. 2008;24 Suppl 1:S3-S6. International Working Group on the Diabetic Foot. Time to act. [regranex.com]

Pathophysiology

• Diabetic foot implies that the pathophysiological process of diabetes m ellitus does something to the foot that puts it at increased risk for “tissue d amage” and the resultant increase in morbidity and maybe amputation (Payne & Florkowski, 1998). [slideshare.net]

Peripheral artery disease: pathophysiology, diagnosis and treatment. Rev Esp Cardiol. 2007;60(9):969–982. [journals.lww.com]

An understanding of the pathophysiology of diabetic ulcers is crucial to the successful treatment of these ulcers, as is knowing how to prevent them from occurring in the first place. [woundeducators.com]

Prevention

[…] treatment or management can be given to prevent wounds from occurring or getting worse. [healthhub.sg]

Remember, the first step to prevention is patient education. [consultant360.com]

Other preventive measures include Do not walk bare feet. Stay off your feet in order to prevent pain and ulcerations. This is called off loading which is helpful with some types of ulcers. Consider wearing diabetic shoes, casts or foot braces. [healthproductsforyou.com]

Preventing Diabetic Ulcers The good news is diabetic foot ulcers can be prevented by careful control of diabetes and proper foot care. [wexnermedical.osu.edu]

Once an ulcer has healed, consistent preventive care will help you stop an ulcer from ever returning. [healthline.com]

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