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Research Paper | Surgery | Libya | Volume 12 Issue 4, April 2023 | Rating: 4.9 / 10
Causal Pathway for Foot Ulceration in a Patient with Diabetes
Dr. Mohamed Elgabsi | Dr. Yousuf Sulayman Asteetah
Abstract: Diabetic foot has a distortion of its anatomy and structural function which influenced by chronic peripheral neuropathy with or without peripheral vascular disease associated with infection, ulceration and destruction of deeper tissues (1, 2, 3, 4,) The annual incidence of foot ulcer world over is 9.1 to 26 per million (5) Diabetic patient carries a lifetime risk of developing a foot ulcer from 15 to 25 % (6) Male gender, hyperglycemia, increase in glycosylated hemoglobin , peripheral neuropathy, previous ulceration and traumas are some of the common risk factors for the development of the diabetic foot ulcers (7) Foot deformity, loss of protective sensation and peripherals vascular disease are important factors (8) The gold standard for diabetic foot ulcer care includes debridement of the wound, management of any infection, revascularization when indicated and offloading of the ulcer (9) Hyperglycemia produces oxidative stress on nerve cell and leads to neuropathy (10) Non enzymatic glycosylation of nerve protein lead to further ischemia. Damaged motor neurons of the foot musculature result in an imbalance of flexor and extensor groups of muscle and result in deformities and skin ulceration. Autonomic nerve impairment causes dryness of skin causing cracks and skin breakdown. blood supply required to heal a diabetic foot ulcer is greater than that needed to maintain skin intact, chronic ulceration can develop (11) Thickening of the basement membrane, the decrease in the size of the capillary lumens and the degeneration of periocysts around venules causes derangement of microcirculation of diabetic foot ulcer (29) The present study is aimed at looking into the pathogenesis of diabetic foot ulceration and its evaluation, classification, and management.
Keywords: Diabetes mellitus, Diabetic foot, ulceration, Diabetic foot ulceration
Edition: Volume 12 Issue 4, April 2023,
Pages: 1743 - 1748