Limb Ulceration and Gangrene - Diabetic Foot Ulcers

Question 1

What are the two main factors that can cause diabetic foot disease?

Answer 1

1. Neuropathy (loss of protective sensation, Charcot’s arthropathy, dry skin).
2. PAD (microvascular and microvascular ischaemia - impairs healing and blood supply).

Question 2

Commonly affected sites of diabetic foot ulcer.

Answer 2

1. Plantar surface of metatarsal head.

2. Plantar surface of hallux.

Question 3

Prevention of Diabetic Foot Ulcers (3).

Answer 3

1. Screen Diabetic patients annually for both ischaemia and neuropathy.
2. Ischaemia - palpate dorsalis pedis and posterior tibial artery pulse.
3. Neuropathy - 10g monofilament on various parts of the sole of the foot.

Question 4

Complications of Diabetic Foot Ulcers (6).

Answer 4

1. Calluses.
2. Ulceration.
3. Charcot’s Arthropathy.
4. Cellulitis.
5. Osteomyelitis.
6. Gangrene.