Diabetic Foot Flashcards
1
Q
Diabetic Foot Pathogenesis
A
- Sensory deficits means no protection against heat and trauma
- Absence of pain contributes to Charcot foot
- Motor abnormalities leads to undue physical stress, further deformities
- Diabetic ischaemia contributes
- Infection can be divided into superficial, soft tissue (cellulitis) and spreading, osteomyelitis
- When infection complicates foot ulcer combination can be limb-threatening
- Detection and prevention is essential
2
Q
Diabetic Foot Epidemiology
A
- 10% of diabetics will develop a foot ulcer
- After first amputation, twice as likely to have subsequent amputation
3
Q
Diabetic Foot Presentation
A
- Usually painless, punched out ulcers in areas of thick callus with infection, pus, oedema, erythema, crepitus, malodour
- Neuro-ischaemic ulcers tend to occur on margins of foot
- Neuropathic foot is without ischaemia warm, dry skin, bounding pulses, distended veins, ulcers tend to occur on plantar surface of foot
4
Q
Diabetic Foot Charcot Foot
A
-Bone and joint degeneration that leads to deformity
5
Q
Diabetic Foot Management
A
- Continue to carry out annual foot assessments
- Education
- Control of glucose, BP, cholesterol, smoking cessation, weight control
- Risk assessment
- Mechanical interventions
- Antibiotics to manage and prevent infection
- Management of peripheral arterial disease
- Wound management
6
Q
Diabetic Foot Referral
A
- If signs of limb or life threatening refer immediately to acute
- Ulceration with fever or sepsis
- Ulceration with limb ischaemia
- Clinical concern of bone infection
- Gangrene
- Think about Charcot arthropathy even if deformity not reported
