ABSTRACT
Diabetic foot ulcers occur in approximately 4% to 10% of patients. It is important to realize that 85% of all diabetic amputations are preceded by foot ulcers, thus making it extremely important to understand the pathogenesis of foot ulceration and strategies to heal them. Preservation of intact skin is very essential. Following are the various risk factors associated with diabetic foot ulcerations:
Primary Risk Factors • Significant polyneuropathy with loss of protective sensations • Evidence of ischemia in foot (ABI <0.9)
Neuropathic foot ulcerations frequently result from two or more risk factors occuring together. In diabetic polyneuropathy all the nerve fibers are affected (sensory, motor and autonomic), which leaves the foot with loss of protective sensations (LOPS). Any damaging stimuli or external trauma are either perceived less or not at all, resulting in an ulcer. Sensory neuropathy is the most important prerequisite for foot ulcerations. All the other factors contribute to foot ulceration only in the presence of sensory neuropathy.
