TRUE/FALSE regarding the management of diabetic foot are: 1. Strict diabetic control 2. Venous system is commonly involved 3. Topical antibiotics are used 4. Early amputation should be done 5. Diabetic ulcers are trophic ulcer
Correct Answer: 1,3,5 true & 2,4 false
Description: About statement 5 Diabetic ulcers in diabetics commonly results from decreased protective sensations because of diabetic neuropathy (trophic ulcer is a neurogenic ulcer), peripheral aerial disease (macroangiopathy), abnormal foot biomechanics and poor wound healing. About statements 1 & 3 Treatment of diabetic ulcers are focused on the strict diabetic control, preventing fuher damage to the area with devices such as custom-fitted ohopedic shoes to eliminate pressure over the metatarsal head (plantar surface of the metatarsal heads and heel are usual site for diabetic ulcers). Necrotic tissue must be debrided and and topical antibiotics may be needed to control local infection. And diabetic patients must be educated to examine their foot routinely which is very impoant to prevent recurrence of these ulcers. About statement 2 It is the peripheral aerial occlusion in combination with neuropathy which results in ulcer diabetic peoples. Venous involvement is not mentioned as the pathophysiologic mechanism in causation of diabetic ulcers. About statement 4 "With the advent of new therapeutic modalities and a multidisciplinary approach, the trend has shifted away from amputation to limb and function preservation" Ref: Sabiston 18/e, Page 2148 ; L & B 25/e, Page 913 ; Textbook of surgery by S. Das 5/e, Page 129 ; Harrison 17/e, Page 2292
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