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diabetic foot, vascular, neuropathy, charcot foot, healing

M Edmonds
This paper describes important aspects of the diabetic foot which the vascular surgeon needs to understand to efficiently manage the diabetic foot. Firstly, it emphasises the three main pathologies which come together in the diabetic foot, namely neuropathy, ischemia and immunopathy, the latter predisposing to infection. As a result of neuropathy, the signs and symptoms of tissue breakdown, infection and ischemia may be minimal. Nevertheless the pathology emanating from such clinical events proceeds rapidly without the body being aware of it and the end stage of tissue death and necrosis is quickly reached...
April 2014: Journal of Cardiovascular Surgery
Zeljko Metelko, Neva Brkljacić Crkvencić
Diabetic foot (DF) is the most common chronic complication, which depends mostly on the duration and successful treatment of diabetes mellitus. Based on epidemiological studies, it is estimated that 25% of persons with diabetes mellitus (PwDM) will develop the problems with DF during lifetime, while 5% do 15% will be treated for foot or leg amputation. The treatment is prolonged and expensive, while the results are uncertain. The changes in DF are influenced by different factors usually connected with the duration and regulation of diabetes mellitus...
October 2013: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
Jan Gessmann, Mustafa Citak, Tobias Fehmer, Thomas Armin Schildhauer, Dominik Seybold
BACKGROUND: The high rates of wound failure, persisting infection, and nonunion of the tibiocalcaneal arthrodesis are the main reasons why the Pirogoff ankle disarticulation is rarely used for limb salvage. Use of the Ilizarov external frame has increased our fusion rate. The purpose of this study was to review our experience with the use of the Ilizarov external frame as a technique for Pirogoff amputations with ankle disarticulation and tibiocalcaneal fusion. METHODS: Twenty-four patients (median age, 57...
June 2013: Foot & Ankle International
J-L Besse, T Leemrijse, P-A Deleu
As diabetes takes on pandemic proportions, it is crucial for the orthopedic surgeon to be aware of the issues involved in diabetic foot. Ulceration is related to neuropathy and to arterial disease, a vital prognostic factor for healing; infection plays an aggravating role, increasing the risk of amputation. At-risk feet need to be screened for. Ulcer classification is essential, to set treatment strategy and determine prognosis. Before any treatment is decided on, neuropathy, vascular insufficiency and infection should individually be assessed by clinical examination and appropriate additional work-up...
May 2011: Orthopaedics & Traumatology, Surgery & Research: OTSR
Luca Dalla Paola, Ezio Faglia
Diabetic foot disease is a major health problem, which concerns 15% of the 200 million patients with diabetes worldwide. Major amputation, above or below the knee, is a feared complication of diabetes. More than 60% of non-traumatic amputations in the western world are performed in the diabetic population. Many patients who undergo an amputation, have a history of ulceration. Major amputations increase morbility and mortality and reduce the patient's quality of life. Treatment of foot complications is one of the main items in the absorption of economic and health resources addressed to the diabetic population...
November 2006: Current Diabetes Reviews
Daniel C Farber, Jerry S Farber
Diabetic foot problems are significant cause of morbidity. With good medical care, the progression of neuropathy and vascular disease can be slowed but not stopped. Effective diabetic foot care requires screening to detect the at-risk foot, prevention to avoid the occurrence of ulcers, and treatment to heal ulcers quickly before they become more significant problems. Screening comprises assessment of patient behaviors and skin, neurologic, and vascular examinations. Prevention is accomplished by patient education and appropriate footwear or bracing...
December 2007: Primary Care
A Jirkovská
The diabetic foot syndrome including foot tissue impairment distally from the ankle associated with neuropathy and angiopathy in diabetic patients is the main cause of amputations. However, amputations are not inevitable and the provision of rapid and intensive treatment of foot complications in multidisciplinary foot clinics can reduce the number of amputations in diabetic patients. The fundamental principle in the therapy is comprehensive approach; the omitting of any of the principle of the therapy may contribute to its failure...
June 2002: Vnitr̆ní Lékar̆ství
A V Foster, S Snowden, A Grenfell, P J Watkins, M E Edmonds
This 4-year prospective study investigated the reasons for high levels of gangrene and major amputation in diabetic renal transplant patients and whether regular multidisciplinary foot care could reduce morbidity. All foot lesions were documented and investigated in 50 diabetic patients, mean age 49.2 +/- 11.0 (SD) years, duration of diabetes 25.3 +/- 9.0 years, time since renal transplantation 60.2 +/- 35.1 months, who attended a special foot clinic monthly for education, vascular and neurological assessment, podiatry and footwear...
July 1995: Diabetic Medicine: a Journal of the British Diabetic Association
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