DIABETIC FOOT ULCER (MALUM PERFORANS PEDIS)
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This is a chronic, painless and clean ulceration that develops because of vascular, neurological and metabolic disorders in diabetes.
Diabetic foot ulcers are usually located under the head of the 2nd or 3rd metatarsal bone or on any other point of normal or abnormal pressure on the underside of the foot.
They can be readily complicated by infections, abscesses or osteitis and frequently result in amputation if untreated.
Diabetes
PATHOPHYSIOLOGY
If the patient does not pay careful attention to their feet, ulcers can develop quickly.
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INCIDENCE/PREVALENCE
Approximately, 15% of diabetic patients have or have had a wound on their feet. The risk of amputation is 15 to 20 times higher in the diabetic population than it is in the general population.
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CHARACTERISTICS
The ulcer takes the form of a wound with well-defined keratinous and sharp edges. The greatest risk is from infection. Typically painless, the patient may be unaware that infection has set in. The foot ulcer provides a gateway for infection that can have long term consequences.
Even in the absence of infection poor blood supply can lead to the establishment of “dry” or diabetic gangrene, where the lack of blood supply causes the affected tissue to slowly die, if there is peripheral arterial occlusive disease the risk of amputation is high.
