DIABETIC FOOT

Dr.Suleiman Jastaniah FRCS (Ed),FACS, Trauma

Fellowship(Toronto university)Associated Prof. College of Medicine

Diabetic foot :• Definition• Causes• Clinical Presentation • Examination• Investigations• Management• Prevention

The most Frequent underlying causes:

1 )Trauma

2 )Neuropathy

3 )Deformity

4 )Peripheral arterial diseases

Clinical presentation: Important points in the history :o Durationo Traumao Dischargeo Fevero Loss of sensationo Diabetic status

Examination: General : Local :

Site Size Shape Edge Floor Base Surrounding tissues – color - Temperature Pulses Sensations Lymph nodes

Signs of infection: pus dischargecrepitusfluctuationdeep tenderness

Red foot------------------ cellulitis Pale or cyanotic------- ischemia Pink foot associated with pain----- severe

ischemia

Pulses are weak in ischemic limb and strong in neuropathic limb

Investigations :•CBC•Chemistry•RBS•Urine for sugar and acetone•Plain X-Ray•Chest X-ray•ECG•Duplux ultrasound

Management: Management of foot ulcer is determined by

its severity, vascularity, and the presence of

infection.

It requires : 1) Knowledge of the major risk factors for

amputation 2)Frequent routine evaluation 3) Meticulous preventive maintenance

Management: General : Local :

• Debridement• Treat the infection• Improve the ischemia

Management Program: Prevention Education Regular foot examinations

-Come to the clinic if you notice : swelling Color changes Thick hard skin or corn

Cracks or blisters Aggressive intervention Optimal use of therapeutic foot wear

Some preventive measures: Do :

• Wash feet daily with mild soap and warm water

• Check feet daily• Seek urgent treatment of any problems• Wear a sensible shoes

Do not :• Use a corn cutters• use a hot water bottles• Walk bare foot• Treat foot problems yourself

في يشتركون الذين الطبي الفريق أفراد: السكري بالقدم العناية

األساسي الطبيب المثقفة المدربة الممرضة العصبية اختصاصي الدموية األوعية جراح العظام جراح الطبيعي العالج أخصائى المنزلية للعناية ممرضه اجتماعي مشرف

THANK YOU