Diabetic Foot Ulceration

etiology 

Diabetic foot ulceration (DFU) normally develops in patients with diabetes who have or have had hyperglycemia. The hyperglycemic state is strongly associated with micro and macrovascular conditions, including neuropathy, retinopathy, nephropathy and peripheral vascular disease.

DFU is normally initiated by trauma whether this is from pressure from footwear causing blistering, a burn e.g. from hot sand / bath water, or acute trauma e.g. standing on a nail. The wound caused by the initial trauma will deteriorate to a DFU if the complications of neuropathy, ischemia or overwhelming infection are present.

They can be categorized as either:

1)Neuropathic Ulceration

Wounds are typically:Diabetic foot ulceration

  • Painless
  • Surrounded by callus
  • Good blood supply to foot

2)Ischemic Ulceration

Wounds are typically:

  • Painful
  • Absent or poor peripheral arterial circulation
  • No callus present
  • Tend to occur on the sides of the foot and toes

3)Neuro-ischemic ulceration

These wounds appear the same as Ischemic ulceration however they will be painless due to the presence of neuropathy.