A Study of Chronic Foot Ulcers for diabetic patients

Abstract

The local factors of the diabetic foot ulcer are peripheral neuropathy, anatomic foot deformity, trauma, improperly fitted shoes, and history of foot ulceration or lower limb elimination in the past, oedema, callus, incomplete joint mobility and irregular foot pressures. There is a triad of neuropathy, trauma and deformity seen in about two-thirds of the diabetic foot ulcer patients. The other risk factors are dry or fissured skin, toe-web tinea and onychomycosis. In some studies, there are sexual differences and ethnic elements.The international agreement on the diabetic foot devised a foot risk criteria with increased risk for foot ulceration by categorizing foot risk. Patients who have no neuropathy and no history of foot ulcer in the past are said to be low-risk patients. The annual occurrence of a diabetic foot ulcer is predictable to be 2 to 3%. There are two important functions of the foot. They support the body weight as well as act as a lever to propel the body during walking and running. The foot is composed of many small bones so that it can adapt itself while walking on uneven surfaces, rather than being made of single bone which makes it harder to walk on such surfaces. Several risk factors act together and lead to the formation of the foot in diabetes patients. It can be approximately separated into local factors and general or systemic factors. The general factors include poor glycemic control, the period of diabetes, peripheral vascular disease, chronic renal disease, visual loss or blindness and old age. The local factors are peripheral neuropathy, anatomic foot deformity, trauma, improperly fitted shoes, history of foot ulceration or lower limb amputation in the past, oedema, callus, imperfect joint mobility and abnormal foot pressures. There is a triad of neuropathy, trauma and deformity seen in about two-thirds of the diabetic foot ulcer patients.