TOTBİD Dergisi

TOTBİD Dergisi

2015, Cilt 14, Sayı, 5     (Sayfalar: 348-354)

The diabetic foot: as a community health problem and its etiopathogenesis

Sabiha Banu Denizeri 1, İlhan Satman 2

1 İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Aile Hekimliği Anabilim Dalı, Çapa, İstanbul
2 İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı, Çapa, İstanbul

DOI: 10.14292/totbid.dergisi.2015.53
Görüntüleme: 167
İndirme : 162

Foot disorders seen in diabetes patients have a high mortality, morbidity and recurrence rate, and affect the patients` quality of life. Due to high expenses they have a huge burden on the economy and can be avoided to a great extent by multidisciplinary approach. Diabetic foot ulcer is a common problem especially in developing countries, growing in concordance with the increasing prevalence of diabetes. Neuropathy due to hyperglycemia, ischemia and repetitive traumas to the foot play a role in the etiopathogenesis. Infection may develop in the chronic wound seen in diabetes due to the reduced function of inflammatory cells, the decrease in growth factors and cytokine levels, a decrease in angiogenesis, and impairment in the matrix turnover. This constitutes a risk factor for lower extremity amputations. Diabetic foot ulcers which have undesired outcomes can be avoided by screening of patients with risk factors, performing foot examination at every visit and educating the patient for possible risks. A multidisciplinary approach is necessary for the follow-up and treatment of the diabetic foot ulcer. Local therapies like appropriate wound care and debridement, off-loading the foot, and vascular interventions in the presence of peripheral vascular disease are crucial for extremity- sparing therapy. But the systemic ones like glycemic control, infection therapy and curing comorbid risk factors including hyperlipidemia and hypertension are as important as wound care. Some emerging adjuvant therapies such as hyperbaric oxygen, negative pressure wound therapy, skin cell graft, growth factors, low energy laser, and platelet-rich plasma are being investigated for their efficacy on the healing of chronic wounds.

Anahtar Kelimeler : diabetes mellitus; foot ulcer, diabetic; wounds, chronic; diabetic neuropathies; multidisciplinary