Diabetic foot

Diabetic foot
Diabetic foot is a complication of diabetes that is pathological processes at the foot of the patient.

Diabetic foot refers to meet most often complicate diabetes and in 85-90% of cases is typical for type II diabetes. Usually starts after 15-25 years of diabetic experience in stage of decompensation and is the most frequent cause of disability of patients with diabetes.

The reasons for the development of
Development of diabetic foot syndrome is a complex mechanism of various processes throughout the body in diabetes. So, with a long course of diabetes, especially when frequent dekompensacijah process, because of the constant sugar spikes from normal to high numbers, occurs a gradual destruction of the blood vessels throughout the body.

It all begins with small capillaries, and culminates in an all-pervasive violation of the blood supply. Along with this process, similar phenomena occur with nerve endings. As a result — metabolic tissues, including the skin surface.

For diabetes is characterized by dryness of the skin, and the feet again and thickening. This is typically called fungal defeat or banal omozolennostju. This skin condition leads to frequent cracks on the foot or other injuries that the patient initially and does not notice due to impaired innervation area.

The scarred skin in healthy people with adequate blood supply heals easily and quickly. And diabetes when disturbed blood flow in vessels, any injury (including light cuts and bruises even) leads to long-nezazhivajushhemu process. To the site of injury joins infection and begins the process of inflammation and nekrotizirovanija (die-off).

Signs of diabetic foot
Complaints and a change in the objective examination by a doctor with diabetic foot depends on the form and stage of the disease.

Symptoms depending on the form of diabetic foot:

Neuropathic form. When is dominated by hitting nerves. Characterized by decreasing the sensitivity on the foot, increasing the pain, patients simply don't feel injured. Stop changing its form, deformed, skin thickens, there are calluses. When an ulcer at the site of injury, their edges will be quite smooth. When the pulse on the arteries of the foot and the colour remained without changes.
Ischemic form. When vascular lesions predominate. Characterized by pobledneniem skin on the feet, its colder than other areas, quite often you can detect swelling. When an ulcer at the site of injury, their edges are uneven, with acute pain.
When the sensitivity and pain persist, do not stop the deformed shape and no corns, but the pulsation of the arteries or not listening, or very weak.
Mixed form. This is the most common form of diabetic foot and includes symptoms and signs of the two previous shapes.
Also, regardless of the form of the disease, on the foot changes depend on the stage of the process:

Stage 0 (risk group). Stop taking deformed shape, there are omozolennosti or skin begins to fade over time and get colder. But no ulcers.
Stage 1. Ulcer occurs only on the surface of the skin without affecting other tissues.
Stage 2. The ulcer extends inland, hitting the skin, fat, muscles and tendons.
Stage 3. The ulcer deepens to the bone.
Stage 4. Occurs a limited stretch of gangrene. A small section of the foot becomes black, has often clearly bounded region.
Stage 5. Gangrene spreads up the foot, turning Shin and above.
Diagnostics
To diagnose diabetic foot, its stages and Forms using the following methods:

Neurological examination;
Blood flow Doppler (ULTRASOUND of blood vessels and blood flow to it);
Angiography (vascular condition survey of the foot);
Radiography stop;
General blood analysis;
Glycemic profile (definition of the blood sugar level throughout the day);
Bacterial sepsis;
Study on the content of the plagues.
Treatment of diabetic foot
Depending on the stage of the patients with diabetic foot can appoint conservative treatment or its combination with surgical methods.

Conservative treatment
To conservative treatment include:

Normalization of blood sugar (insulin, saharosnizhajushh e drugs)
Antibiotics broad-spectrum (prescribed individually, depending on the results obtained from the contents of the ulcers)
Painkillers (Diclofenac, ibuprofen, Analgin)
Drugs improve blood flow in the vessels (Pentoxifylline, Нормовен, Agapurin)
Local antiseptic and antibacterial drugs (prescribed individually, depending on the results obtained from the contents of the ulcers)
Surgical treatment of dabeticheskoj foot
The following methods are used:

Angioplasty (restoration of patency of vessels by plastics receptacles).
Endarterectomy (removing non-restorable vessels and blood flow to run additional branches).
Autovenous bypass (create additional branches of the bloodstream, bypassing the struck vessels from small fragments of their own veins).
Stenting arteries of the lower extremities (installation on the vascular wall special compartments, or other objects that support vessels from spadenija).
Forecast
At risk are about 50% of all patients with diabetes, diabetic foot, however, develops only 10% of the total number of diabetchikov.

After the timely holding of adequate treatment and compliance with doctor's recommendations risk re-development is not more than 1%.