Foot Ulcers Flashcards
Why do diabetics get dry feet?
They loss the ability to sweat
What are alkaline phosphatase levels tested in ulcers?
RIsing ALP is associated with osteomyelitis
How can suspected osteomyelitis be investigated?
Xray - however it takes time for changes to appear
Tc99 bone scan - more sensitive but non-specific
MRI - gold standard for osteomyelitis
What are the amputation options?
Toe
Transmetatarsal
Ankle
Below knee
Through knee
Above knee
What fraction of T2 diabetics develop peripheral neuropathy?
10% at diagnosis
50% at 20 years
What are the pathological contributing factors to a diabetic foot ulcer?
Diabetes
Peripheral vascular disease
Peripheral neuropathy
Infection
What are some investigations used for ulcers?
Duplex US
Angiogram
Toe pressures
What is probe to bone?
A probe is placed in the wound to see if it reaches the bone
What is cheiroarthropathy?
Reduced mobility of joint in diabetics
What is the TIME principle for wound management?
T - Tissue non viable- remove defective tissue
I - inflammation or infection - reduce bacterial load
M - Moisture balance
E - Edge of wound not advancing
What does a sausage toe look like? What does it reflect?
Swollen and erythematous with loss of normal contours
No pitting oedema
Osteomyelitis
What are two blood markers for osteomyelitis?
ALP
ESR
What are the phases of amputation management?
Pre-op
Acute Post-op
Pre-prosthetic
Prosthetic design
Prosthetic gait training
Community integration
Follow up
How often does phantom limb pain occur?
30-81% of the time
