Introduction
Diabetic foot ulcers are rated as one of the principal causes of diabetes mellitus hospitalization in the US and worldwide. Diabetic foot disease causes complications which account for huge medical expenses. For instance, in the UK, it is reported that NHS spends five million pounds annually on diabetes foot ulcers. Studies show that 100 patients lose their lower limb of their foot as a result of diabetic foot disorders (Nicholas, 2013). Diabetic foot ulcers result into amputations. Furthermore, the death rates due to amputations are reported to be approximately 50% from the patients who suffered diabetic foot ulcers (Edmonds, 2006). Though the basic pathogeneses are immunopathy, neuropathy, and vasculopathy, foot ulcers are also …show more content…
Intrinsic problems that come from diabetes Mellitus, extrinsic causes predispose the individual to risk the development of foot lesions. The major predisposing factors that lead to foot lesions are peripheral arterial sickness, peripheral neuropathy trilogy and immunopathy (susceptibility to infections). Peripheral neuropathy could have minimal effect on little symptoms hence making it not to be easily identified. However, its pathology does advance faster causing the ending stage the tissue necrosis to reach quickly. Patients who have type 2 diabetes are estimated to be 20% to 50% distal sensory neuropathy this reduces the sensation in the person 's foot causing the abnormal spread of shear stresses and pressure in the foot with a callus builds up (Pendsey, 2014). Due to this, the patient’s capability to perceive small trauma in the feet and this can be seen through “vibration perception threshold” (VPT). Furthermore, there is 10g monofilament insensitivity that portrays 18-fold and 7-fold risks of causing ulceration of the foot. Also, distal autonomic neuropathy can spark foot ulceration. It does cause a reduction in the foot sweating leading to cracking and drying of the …show more content…
A quick inspection of the person shoes to see if they are fitting, wear and tear patterns and any foreign objects is important before doing any physical examinations on the foot. Clinical assessment has to include appropriate evaluation of the ulcer depth, extent, and etiology. The presence of systemic and local infections has to be identified. There has to be an evaluation of the patient 's general health status which is comprehensive. Musculoskeletal and dermatologic evaluations should also be included in the examination. All these tests determine the rate at which the ulcer will heal, the probability of its reoccurrence and the likely progression to lower extremity amputations (LEA) . Bilateral lower limb pulse has to be evaluated. If it is noticed that the pulses are not palpable or diminish, TcpO2 or Doppler segmental pressure measurements are noted, and a vascular expert should be brought forward. Assessment of the neurology has to examine the deep tendon reflexes and sensorium of the patient. Knee and ankle reflexes are tested with the help of a neurological hammer. The sense of pain is made with a disposable needle while cold sensation is examined through submerging it into cold
Diabetic foot ulcers are rated as one of the principal causes of diabetes mellitus hospitalization in the US and worldwide. Diabetic foot disease causes complications which account for huge medical expenses. For instance, in the UK, it is reported that NHS spends five million pounds annually on diabetes foot ulcers. Studies show that 100 patients lose their lower limb of their foot as a result of diabetic foot disorders (Nicholas, 2013). Diabetic foot ulcers result into amputations. Furthermore, the death rates due to amputations are reported to be approximately 50% from the patients who suffered diabetic foot ulcers (Edmonds, 2006). Though the basic pathogeneses are immunopathy, neuropathy, and vasculopathy, foot ulcers are also …show more content…
Intrinsic problems that come from diabetes Mellitus, extrinsic causes predispose the individual to risk the development of foot lesions. The major predisposing factors that lead to foot lesions are peripheral arterial sickness, peripheral neuropathy trilogy and immunopathy (susceptibility to infections). Peripheral neuropathy could have minimal effect on little symptoms hence making it not to be easily identified. However, its pathology does advance faster causing the ending stage the tissue necrosis to reach quickly. Patients who have type 2 diabetes are estimated to be 20% to 50% distal sensory neuropathy this reduces the sensation in the person 's foot causing the abnormal spread of shear stresses and pressure in the foot with a callus builds up (Pendsey, 2014). Due to this, the patient’s capability to perceive small trauma in the feet and this can be seen through “vibration perception threshold” (VPT). Furthermore, there is 10g monofilament insensitivity that portrays 18-fold and 7-fold risks of causing ulceration of the foot. Also, distal autonomic neuropathy can spark foot ulceration. It does cause a reduction in the foot sweating leading to cracking and drying of the …show more content…
A quick inspection of the person shoes to see if they are fitting, wear and tear patterns and any foreign objects is important before doing any physical examinations on the foot. Clinical assessment has to include appropriate evaluation of the ulcer depth, extent, and etiology. The presence of systemic and local infections has to be identified. There has to be an evaluation of the patient 's general health status which is comprehensive. Musculoskeletal and dermatologic evaluations should also be included in the examination. All these tests determine the rate at which the ulcer will heal, the probability of its reoccurrence and the likely progression to lower extremity amputations (LEA) . Bilateral lower limb pulse has to be evaluated. If it is noticed that the pulses are not palpable or diminish, TcpO2 or Doppler segmental pressure measurements are noted, and a vascular expert should be brought forward. Assessment of the neurology has to examine the deep tendon reflexes and sensorium of the patient. Knee and ankle reflexes are tested with the help of a neurological hammer. The sense of pain is made with a disposable needle while cold sensation is examined through submerging it into cold