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Case 1.1
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
These injuries commonly have a poor outcome, so an early recommendation for an amputation may provide a functionally equivalent outcome with a shorter rehabilitation period. This is because of the following:Joint stiffness and chronic pain are common, due to the ligamentous and bony injury altering the mechanics of the foot.In addition, the loss of plantar skin is very difficult to reconstruct.Salvage of early post-traumatic degeneration of joints will need arthrodesis, leaving the patient with the functional equivalent of a below-knee amputation.
Diabetes Mellitus, Obesity, Lipoprotein Disorders and other Metabolic Diseases
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Foot problems in diabetes can be caused by peripheral vascular disease, peripheral neuropathy or both. The severity of each should be assessed with a problem diabetic foot (Table 11.10). The most common clinical problem is a non-healing foot ulcer. Ulcers occur because of increased pressure at points on the foot and/or reduced skin nutrition from poor blood supply. Once an ulcer has formed and the epithelial barrier is breached, infection can occur, further reducing the likelihood of healing.
Host-Parasite Relationships
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Parasitism is a life-style that has been adopted by many types of living things. There are parasitic forms among most groups of multicellular plants and animals, among the fungi, and in most groups of unicellular organisms. All viruses are parasites. There are many species of parasites which inhabit the bodies of plants and animals. Examples of parasitic flowering plants are dodder, indian pipe, and mistletoe. Various species of hookworms, ascarids, and trichinella are common in humans and other animals, and many species of nematode infest the roots of plants. The organism that causes athlete′s foot is a parasitic fungus. Unicellular protozoa cause malaria, dysentery and other diseases. A large variety of species of bacteria are parasitic; anthrax, diphtheria, tuberculosis, and brucellosis, for example, are diseases caused by parasitic bacteria (Figure 2.1).
Effect of an educational intervention based on the Theory of Planned Behaviour in type 2 diabetic patients at a foot and eye care practice
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
B Pezeshki, S Orangi, SM Kashfi, P Afzali Harsini, F Mohammadkhah, A Khani Jeihooni
Diabetes is one of the most prevalent chronic diseases on a global scale.1 Due to the expanding number of affected individuals and the disease’s severity, these individuals should seek immediate medical assistance.2 Lack of precise blood glucose monitoring has been identified as a major issue for diabetics.3,4 According to the World Health Organization (WHO), diabetes affects over 346 million people globally. Without intervention, this figure is anticipated to more than double by 2030.5 By 2030, it is anticipated that 9.2 million Iranians will have diabetes.6 Diabetes patients are at an increased risk of developing acute and fatal complications (diabetic retinopathy, peripheral neuropathy, myocardial infarction, peripheral vascular disease, end-stage renal disease, and diabetes-related foot problems and amputation) due to poor blood sugar control.7 In the absence of therapy, diabetic foot is one of the most serious and debilitating complications of diabetes, resulting in infection, soft-tissue infection or necrosis, and amputation.8 Jordan believes that with attentive care, 80–85% of diabetic foot amputations can be avoided. Optimal diabetic foot management entails doing daily self-foot inspections, frequently washing and drying feet, avoiding walking barefoot, using orthopaedic shoes, clipping toenails straight across, avoiding manipulation of calluses and corns, and consulting a doctor on a regular basis.9
Footwear characteristics and foot problems in community dwelling people with stroke: a cross-sectional observational study
Published in Disability and Rehabilitation, 2023
Dorit Kunkel, Louis Mamode, Malcolm Burnett, Ruth Pickering, Dan Bader, Margaret Donovan-Hall, Mark Cole, Ann Ashburn, Catherine Bowen
Although 70% of respondents in our previous survey [12] indicated that they felt their current indoor shoes “were right for them”, when assessed by a podiatrist we found that only 50% of the shoes worn by participants in the current study fitted well. A systematic review concluded that between 63 and 73% people wore poorly fitting shoes, highlighting that this is a very common problem [34]. Worryingly even bespoke shoes supplied and worn with a foot orthosis did not fit well in all cases. Evidence shows that shoe fit is important [34] and that correctly fitted ankle-foot orthosis can have a beneficial effect on gait post stroke [35]. It is argued that poorly fitted shoes might not allow the ankle foot orthosis to fulfil its intended purpose. Poorly fitting shoes have been linked to the development of foot problems including toe deformities, pain, skin lesions, hallux valgus, corns, and calluses [34].
Effect of leukocyte-platelet fibrin-rich wound reconstruction followed by full-thickness skin grafting in the treatment of diabetic foot Wagner grade 4 ulcer gangrene (toe area)
Published in Platelets, 2023
Yuqi Wang, Yanyan Wang, Xiaotao Wang, Yi Zhao, Siyuan Ruan, Hong Cao
Diabetic foot is one of the most serious complications of diabetes and the leading cause of nontraumatic amputation. According to statistics, the total incidence of diabetic foot ulcers in the world is approximately 6.3%, and approximately 25% of patients have ulcer wounds that will not heal for the rest of their lives. At the same time, the probability of ulcer recurrence after ulcer healing is as high as 60%, and the extremely high recurrence rate of ulcers also increases the risk of amputation [1,2]. The gradual subsidence of limb sensation also makes the affected limb vulnerable to trauma but unable to be treated in time, which aggravates foot ulcers; such trauma includes friction from shoes, impact and crushing from objects, scalding, and even burns, which especially affect the toes of the diabetic foot [3,4]. In the most commonly used Wagner classification of diabetic foot ulcers, localized gangrene of the toes, heels or dorsum of the forefoot (grade 4) is second only to gangrene of the affected limb (grade 5) and is an extremely difficult wound to manage. The appearance of localized gangrene marks the destruction of the local blood supply and irreversible necrosis of soft tissue structures, often accompanied by local infection and soft tissue defects (mostly combined with trauma). If not handled properly, this condition can easily develop into larger areas of ulcers and gangrene and eventually lead to amputation (e.g., toe amputation) [1,5].