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Caring for a diabetic ulcer:Nursing Magazine:"An ulcer caused by arterial insufficiency or trauma or excess pressure undetected by the patient because of neuropathy. The border is undefined and may be small at the surface, although the wound may have a large subcutaneous abscess. Drainage usually is absent unless the ulcer is infected. The ulcer pictured at right is grade 3 on the Wagner Ulcer Classification System because of the presence of osteomyelitis.
DIABETIC ULCERS AFFECT 18% OF PERSON over age 65 who have diabetes, and foot problems affect 15% to 20% of all diabetic patients. Because foot problems in patients with diabetes can be costly, both economically and emotionally, and can lead to more serious complications, your assessment and treatment of the patient are crucial. Developing a proactive plan is your first step."
http://www.findarticles.com/p/articles/mi_qa3689/is_199905/ai_n8848414
Foot Care For Diabetes:intelihealth:"Two risk factors come together to make the feet in people with diabetes particularly vulnerable. The combination of peripheral vascular disease — inadequate circulation of blood to the extremities — and peripheral neuropathy, which deadens the sensation in the feet of many people with diabetes, lead to a high incidence of foot problems for people with diabetes. Amputation is another dreaded complication of this disease. Today, with new wound-treating technology and better preventive care, amputation can be avoided in most cases."
http://www.intelihealth.com/IH/ihtIH/WSIHW000/21054/24347/231721.html?d=dmtContent
Diabetic foot ulcers, diagnosis and classification:American Academy of Family Physicians:"Meticulous attention to foot care and proper management of minor foot injuries are key to preventing ulcer formation. Daily foot inspection by the patient (or a caretaker if the patient lacks sufficient visual acuity or mobility to perform the examination) is the cornerstone of proper foot care. Gentle cleansing with soap and water, followed by the application of topical moisturizers, helps to maintain healthy skin that can better resist breakdown and injury"
http://www.aafp.org/afp/980315ap/armstron.html
Diabetic Ulcers:e Medicine:"Diabetic foot ulcers occur as a result of a variety of factors. Such factors include mechanical changes in conformation of the bony architecture of the foot, peripheral neuropathy, and atherosclerotic peripheral arterial disease, all of which occur with higher frequency and intensity in the diabetic population. Nonenzymatic glycosylation predisposes ligaments to stiffness. Neuropathy causes loss of protective sensation and loss of coordination of muscle groups in the foot and leg, both of which increase mechanical stresses during ambulation."
http://www.emedicine.com/med/topic551.htm
Diabetic Foot Ulcers:foot.com:"Nonhealing foot ulcerations, secondary to diabetes, have been implicated in up to 90 percent of all amputations in several world centers including Japan, Taiwan, Spain, Italy, Canada, the United States and England. Prompt healing of ulcerations can prevent many of these amputations and likewise improve the quality of life for affected individuals. Approximately 2.35 million diabetic foot ulcers are diagnosed per year in the United States. The incidence of chronic wounds is expected to increase dramatically in the future due to the increasing incidence of diabetes and other health-related disorders associated with developing chronic wounds. The US diabetes rate alone may increase up to 165 percent over the next 50 years"
http://news.foot.com/news/1159.html
Diabetic Ulcers:bttc.org:"Diabetic ulcers usually occur on the foot of diabetic patients. There are two main causes of diabetic ulcers:
Arterial Insufficiency
Diabetic Neuropathy
In a diabetic patient, an ulcer caused by arterial insufficiency follows the same etiology as a non-diabetic arterial insufficiency ulcer"
http://www.bttc.org/woundcare/diabeticulcers.html
Diabetic foot ulcer-what's going on in the body?:Discovery Health Channel:"A person with diabetes often has peripheral vascular disease, or decreased circulation to the legs and feet. Any damage to the feet may heal slowly because of the poor circulation. The person may also have diabetic neuropathy, a condition in which nerve damage from diabetes causes decreased sensation in the legs and feet. The person can develop an open area from pressure or from a cut and not even feel the sore. Untreated, the damaged area can develop a diabetic foot ulcer."
http://health.discovery.com/diseasesandcond/encyclopedia/2759.html
Diabetic food ulcers:UPMC Health System:"To effectively promote the healing of diabetic foot ulcers, University of Pittsburgh Medical Center (UPMC) orthopaedic surgeons prescribe special foot casts, called total contact casts. The casts are made of soft cotton wrapping underneath a layer of fiberglass stripping and are specifically formed to each patient's foot, this relieving pressure from the ulcers and allowing them to heal. The casts allow the patients to remain mobile instead of non-weight-bearing during the healing process."
http://www.upmc.edu/newsbureau/sportsmed/diabetic_foot_ulcers.htm
Diabetic foot ulcers-what are the sypmtoms and self care treatment?:Penn State Milton S. Hershey Medical Center:"A foot ulcer looks like a painful, red sore on the foot. When infected, it will ooze pus and have a foul-smelling discharge.You can help prevent foot ulcers by practicing good foot care. This includes keeping your feet clean and dry each day; keeping your toenails cut straight across, preferably by a podiatrist; checking your feet daily for any cracks or sores; wearing well-fitting shoes; and following your doctor’s treatment plan for controlling your blood sugar levels"
http://www.hmc.psu.edu/healthinfo/d/footulcers.htm
Prevention is the Best Cure for Diabetic Foot Ulcers:Diabetes Solution:"The incidence of limb-threatening ulcerations is very high, affecting about one of every seven diabetic patients. Non-healing "diabetic" ulcerations are responsible for the largest group of leg, foot and toe amputations in this country, after traumatic injuries such as motor vehicle accidents.
These ulcers and subsequent amputations are always preceded by either gradual or sudden injury to the skin by some external intrusion. By preventing such injuries, we can prevent their sad consequences.
Virtually all diabetics who have experienced ongoing higher-than-normal blood sugars for more than five years suffer some loss of sensitivity to pain, pressure, and temperature in their feet."
http://www.diabetes-normalsugars.com/articles/foot_ulcers.shtml
Foot ulcers affect 15 percent of all diabetic patients:American College of Foot and ankle Surgeons:"Foot ulcers affect 15 percent of all diabetic patients
Giurini said that prompt and aggressive treatment of foot ulcers can prevent worsening and help accelerate healing. Diligent self care also is a key component for early detection.
"We recommend that diabetic patients inspect their feet every day, wear shoes that fit properly and minimize pressure, and maintain their blood glucose levels within the desired range," Giurini explained. "Regular visits to a podiatric foot and ankle surgeon for removal of calluses and ingrown toenails provide an opportunity to reinforce self-care behavior and detect new or impending foot problems.""
http://www.acfas.org/prdiabeticulcers.html
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