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Diabetic Neuropathy (Treatment (CONSEQUENCE - DIABETIC FOOT ULCERATION…

- - - - Neuropathy results in increased risk of 'silent trauma', that is patient injures foot, but is not aware of it
      - Furthermore, neuropathy results in autonomic features that result in increased skin dryness of the foot which is more susceptible to cracking and thus increases the risk of ulcer formation
      - This can result in ulcer formation and ischaemia results in failure of ulcer to heal
      - This can lead to infection and can eventually result in amputation
    - - Painless, punched-out ulcer of foot in an area of thick callus
    - - Many foot problems are avoidable so patients must be educated
      - Check feet daily (to detect ulcers early), seek early advice, check shoes for sharp bodies
      - DO FOOT SCREENING!
      - Tie laces leaving enough room for toes
      - Keep feet away from heat and check bath temperature before stepping in
      - Four main threats to skin and subcutaneous tissue
        
        Infection - can take hold rapidly (early antibiotics are essential)
        
        Ischaemia - blood flow is assessed using Doppler ultrasound
        
        Abnormal pressure - ulcerated sites must be kept non-weight bearing, patient should wear special shoes and insoles
        
        Wound infection - dressing used to absorb or remove exudes, maintain moisture and protect wound