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Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Intrinsic atrophy of foot and ankle muscles leads to anatomic changes of the foot arch, most commonly depressing the metatarsal heads and creating high pressure zones. [8] Neuropathy is present in approximately 60% of patients who develop foot ulcers and are also diabetic. [ 4 ]
Around half of the patients with a diabetic foot ulcer have co-existing PAD. [5] [6] Vitamin D deficiency has been recently found to be associated with diabetic foot infections and increased risk of amputations and deaths. [7] Research estimates that the lifetime incidence of foot ulcers within the diabetic community is around 15% and may ...
Foot of an 80-year old individual with type 2 diabetes and heart failure. The second toe has a large ischaemic ulcer. The first toe has a small one. The prevalence of arterial insufficiency ulcers among people with Diabetes is high due to decreased blood flow caused by the thinning of arteries and the lack of sensation due to diabetic neuropathy.
Total contact casting (TCC) is a specially designed cast designed to take weight off of the foot (off-loading) in patients with diabetic foot ulcers (DFUs). Reducing pressure on the wound by taking weight off the foot has proven to be very effective in DFU treatment.
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Calluses (plantar in right foot and medial in left foot) A callus (pl.: calluses) is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, but they may occur anywhere on the skin.