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- Title
MANAGING ULCERS OF DIABETIC FOOT.
- Authors
TOSHEV, Slavcho; GRUEVA, Lujza
- Abstract
During the lifetime, 20-25% of patients with diabetes will be healing ulcers (wounds) on the foot. Risk factors for these ulcers are: age, sex, duration of the diabetes, control of blood glucose levels, trauma or former deformities of the foot. The clinical examination is based on the assessment of the skin, the vascular, neurological, muscular and skeletal system of the legs. Early diagnosis, risk stratification and appropriate therapy are key to prevent the complications, before the amputation. The debridement of the wound, managing the infection and off-loading the surface where the ulcer is located are the most important principles of the treatment of the diabetic ulcers of the foot. Hyperbaric oxygen therapy and usage of contemporary products for the healing of the wound, (products with growth factor or platelet -rich plasma) are useful additional therapeutic medicines. Lowering of the pressure on the ulcer is a technique which speeds up the recovery, and is especially important in healing plantar ulcers. Deep infection of the foot is common in already appeared ulcers. The main components in the treatment are: surgical approach, antibiotic therapy, taking care of the wound, therapy for metabolic and other comorbidities, frequent assessment of the response of the treatment, orthopedic and podiatric management. Depending on the intensity of the infection, the infection can threaten the extremity or it can be an infection which does not threaten the extremity. In case of an infection which threatens the extremity urgent hospitalization and intensive care are necessary. Experiences in Canada and Australia where are implemented state programs for informing, early detection, risk categorization, and healing according to appropriate protocols has reduced the number of amputated legs in 10 years period in 50%. In Republic of Macedonia till now there is no center for diabetic foot, and the diagnosis and healing are managed in more institutions, it is not enough standardized, and patients lose lots of time from one to the other institution with which the curative effect is reduced.
- Publication
Vizione, 2017, Issue 28, p59
- ISSN
1409-8962
- Publication type
Article