DIABATIC FOOT ULCERS
DIABETIC FOOT ULCERS
Diabetic ulcers are the most common foot injuries
leading to lower extremity amputation. Family physicians have a pivotal
role in the prevention or early diagnosis of diabetic foot
complications. Management of the diabetic foot requires a thorough
knowledge of the major risk factors for
amputation, frequent routine
evaluation and meticulous preventive maintenance. The most common risk
factors for ulcer formation include diabetic neuropathy, structural foot
deformity and peripheral arterial occlusive disease. A careful physical
examination, buttressed by monofilament testing for neuropathy and
noninvasive testing for arterial insufficiency, can identify patients at
risk for foot ulcers and appropriately classify patients who already
have ulcers or other diabetic foot complications. Patient education
regarding foot hygiene, nail care and proper footwear is crucial to
reducing the risk of an injury that can lead to ulcer formation.
Adherence to a systematic regimen of diagnosis and classification can
improve communication between family physicians and diabetes
subspecialists and facilitate appropriate treatment of complications.
This team approach may ultimately lead to a reduction in lower extremity
amputations related to diabetes.
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