Diabetic foot ulcer

Diabetic foot ulcer
Neuropathic diabetic foot ulcer
Causesdiabetes

Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease.[1] It is a major complication of diabetes mellitus, and it is a type of diabetic foot disease. Secondary complications to the ulcer, such as infection of the skin or subcutaneous tissue, bone infection, gangrene or sepsis are possible, often leading to amputation.[1]

A key feature of wound healing is stepwise repair of lost extracellular matrix (ECM), the largest component of the dermal skin layer.[2] However, in some cases, physiological insult or disorder - in this case, diabetes mellitus - impedes the wound healing process. In diabetic wounds, the inflammatory phase of the healing process is prolonged, delaying the formation of mature granulation tissue and reducing the healing wound's tensile strength.[3]

Treatment of diabetic foot ulcers includes blood sugar control, removal of dead tissue from the wound, wound dressings, and removing pressure from the wound through techniques such as total contact casting. Surgery in some cases may improve outcomes.[4] Hyperbaric oxygen therapy may also help but is expensive.[4]

34% of people with diabetes develop a diabetic foot ulcer during their lifetime, and 84% of all diabetes-related lower-leg amputations are associated with or result from diabetic foot ulcers.[5]

  1. ^ a b Cite error: The named reference Armstrong 2023 was invoked but never defined (see the help page).
  2. ^ Nomikos Iakovos N, et al. (2006). "Protective and Damaging Aspects of Healing: A Review". Wounds. 18 (7): 177–185.
  3. ^ McLennan S, et al. (2006). "Molecular aspects of wound healing" (PDF). Primary Intention. 14 (1): 8–13. Archived from the original (PDF) on 2010-05-24. Retrieved 2009-05-28.
  4. ^ a b Yazdanpanah L, Nasiri M, Adarvishi S (February 2015). "Literature review on the management of diabetic foot ulcer". World Journal of Diabetes. 6 (1): 37–53. doi:10.4239/wjd.v6.i1.37. PMC 4317316. PMID 25685277.
  5. ^ Cite error: The named reference pmid24796080 was invoked but never defined (see the help page).