EFFECT OF HYPERBARIC OXYGEN THERAPY IN IMPROVING RESULTS OF DIABETIC FOOT RECONSTRUCTION
Radwa Abd El-Rahman Abd El-Samea Farrag;
Abstract
Knowing the anatomy of the foot is essential so that progression of disease in the diabetic foot can be understood and proper treatment applied.
Effective clinical evaluation and effective treatment are based on understanding of the gross anatomy and of alteration produced by disease.
Diabetes is a growing problem in the current modern society. It is difficult to estimate the total number of population suffering from this problem, as a large number of people are not aware that they are diabetic. Approximately 20% of the patients of diabetes will develop foot ulcer in their life time. Diabetic foot ulceration is a major problem as it can impair the quality of patient's life. In addition the cost to treat diabetic foot ulcer is huge. Foot ulcer in diabetic is mainly due to peripheral neuropathy and vascular disease with unrecognized repetitive trauma. They usually have both sensory and motor neuropathy. Minor trauma goes unrecognized, as the patient is unaware due to loss of pain protective sensation. There after repetitive trauma leads to ulceration. Motor neuropathy result in foot deformity. This is caused when muscle imbalance with resultant bony prominence exert increased planter pressure.
Both large and small vessels are affected in diabetics due to superadded atherosclerotic changes. As a result the healing process is slow. High blood sugar can lead to defective defense mechanism of white blood cell making them susceptible to infection. Poor nutrition, psychological depression and stress have been shown to impair immune system. In addition poor eyesight can hamper early recognition of the ulcer.
Prevention of foot lesions begins with careful regulation of metabolic status. Also the doctor dealing with these cases of diabetic lesions should realize the significance of problems in diabetic foot. Also, because of the occurrence of neuropathy and vascular disease cannot be totally prevented, major therapeutic approach is through education of the foot care. The diabetic patient has to be educated how to take care of his feet.
It is well known that acute infections lead to difficulty in controlling blood sugar levels and that infection is the most frequently documented cause of ketoacidosis. So the control of hyperglycemia and infection are related to each other and it should be managed at the same time especially if surgical interference will be indicated.
Effective clinical evaluation and effective treatment are based on understanding of the gross anatomy and of alteration produced by disease.
Diabetes is a growing problem in the current modern society. It is difficult to estimate the total number of population suffering from this problem, as a large number of people are not aware that they are diabetic. Approximately 20% of the patients of diabetes will develop foot ulcer in their life time. Diabetic foot ulceration is a major problem as it can impair the quality of patient's life. In addition the cost to treat diabetic foot ulcer is huge. Foot ulcer in diabetic is mainly due to peripheral neuropathy and vascular disease with unrecognized repetitive trauma. They usually have both sensory and motor neuropathy. Minor trauma goes unrecognized, as the patient is unaware due to loss of pain protective sensation. There after repetitive trauma leads to ulceration. Motor neuropathy result in foot deformity. This is caused when muscle imbalance with resultant bony prominence exert increased planter pressure.
Both large and small vessels are affected in diabetics due to superadded atherosclerotic changes. As a result the healing process is slow. High blood sugar can lead to defective defense mechanism of white blood cell making them susceptible to infection. Poor nutrition, psychological depression and stress have been shown to impair immune system. In addition poor eyesight can hamper early recognition of the ulcer.
Prevention of foot lesions begins with careful regulation of metabolic status. Also the doctor dealing with these cases of diabetic lesions should realize the significance of problems in diabetic foot. Also, because of the occurrence of neuropathy and vascular disease cannot be totally prevented, major therapeutic approach is through education of the foot care. The diabetic patient has to be educated how to take care of his feet.
It is well known that acute infections lead to difficulty in controlling blood sugar levels and that infection is the most frequently documented cause of ketoacidosis. So the control of hyperglycemia and infection are related to each other and it should be managed at the same time especially if surgical interference will be indicated.
Other data
| Title | EFFECT OF HYPERBARIC OXYGEN THERAPY IN IMPROVING RESULTS OF DIABETIC FOOT RECONSTRUCTION | Other Titles | تأثير العلاج بالأكسجين تحت الضغط العالي في تحسين نتائج إعادة إعمار القدم السكري | Authors | Radwa Abd El-Rahman Abd El-Samea Farrag | Issue Date | 2014 |
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