Document Detail


Diabetic foot ulcers--a comprehensive review.
MedLine Citation:
PMID:  17849958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As the incidence of diabetes mellitus is increasing globally, complications related to this endocrine disorder are also mounting. Because of the large number of patients, foot ulcers developing in the feet of diabetics have become a public health problem. The predisposing factors include abnormal plantar pressure points, foot deformities, and minor trauma. Vulnerable feet usually already have vascular insufficiency and peripheral neuropathy. The complex nature of these ulcers deserves special care. The most useful prognostic feature for healing remains the ulcer depth, ulcers heal poorly if they clearly involve underlying tendons, ligament or joints and, particularly, when gangrenous tissue is seen. Local treatment of the ulcer consists of repeated debridement and dressing. No 'miraculous' outcome is expected, even with innovative agents like skin cover synthetics, growth factors and stem cells. Simple surgery like split skin grafting or minor toe amputations may be necessary. Sophisticated surgery like flap coverages are indicated for younger patients. The merits of an intact lower limb with an abnormal foot have to be weighed against amputation and prosthesis in the overall planning of limb salvage or sacrifice. If limb salvage is the decision, additional means like oxygen therapy, and other alternative medicines, might have benefits. The off-loading of footwear should always be a major consideration as a prevention of ulcer formation.
Authors:
P C Leung
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland     Volume:  5     ISSN:  1479-666X     ISO Abbreviation:  Surgeon     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-09-13     Completed Date:  2007-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101168329     Medline TA:  Surgeon     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  219-31     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Room 74026, 5th Floor, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong. pingcleung@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
Amputation*
Debridement*
Diabetic Foot / epidemiology*,  therapy*
Hong Kong / epidemiology
Humans
Incidence
Prognosis
Risk Factors
Skin Transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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