health articles this time of diabetic foot ulcers
One of the complications of diabetes mellitus is a common diabetic foot, which can manifestation as ulcers, infections and gangrene, and Charcot artropati.
Approximately 15% of patients with diabetes mellitus (DM) on the way the disease will develop complications, especially gastric ulcer diabetika on foot. Approximately 14-24% of patients require diabetika leg amputation action.
Musha A reported one in 5 people with ulcers require action amputasi.2 DM Based on descriptive studies reported that 6-30% of patients who have experienced amputation would later re-runs the risk of amputation within 1-3 years after the first amputation.
Ebskov B. reported, as many as 23% of patients require re-ipsilateral limb amputation within 48 months after the first amputation.
Risk of amputation occurs when there are factors;
* Peripheral neuropathy,
* Deformities of bone,
* Vascular insufficiency,
* A history of ulcer / amputation and
* Severe nail pathology disorders.
Peripheral neuropathy has a very large role in the occurrence of foot protection diabetika loss of pain sensation, especially in the legs. More than 80% against the backdrop of DM foot neuropathy.
Ulcer treatment either conservative or amputation requires a very expensive cost.
The average cost of treatment needed $ diabetika feet 2687/pasien / year or $ 4595/ulkus/episode, 80% of the fee used to pay for hospitalization.
Management foot diabetika primarily focused on preventing and avoiding the lower limb amputation. The efforts conducted by:
1. To identify patients who have a high risk of amputation
2. Provide immediate and effective treatment in situations where an interruption of acute wounds.
Before therapy, a doctor who will treat patients with diabetic foot ulcers should be able to assess diabetic foot as a whole, assess the presence or absence of infection, to identify the causes of ulcers and wound healing penyulit factors.
More than 90% of ulcers will heal if treated in a comprehensive and multidisciplinary.
Management feet done diabetika team, which involves a lot of expertise, such as: disease in (endocrinology, Nephrology, Cardiology, infection), surgery (vascular, podiatric, plastic, orthopedic), a shoe, physiotherapists, nurses, nutritionists, physiotherapists, and forth. Based on field experience in diabetic foot management is still fragmented, not carried out multidisciplinary.
Without a team approach, certain specialists tend to do therapy that focuses on his own specialty. For example, orthopedic surgeon focusing only debridemen or amputation and less thinking of metabolic control, nutrition, wound care, prevention of ulcer re-occurrence, of a shoe according to the needs of patients. Diabetic ulcer management needs to be done through a multidisciplinary and comprehensive efforts; komorbid overcome disease, eliminate / reduce the pressure load (off loading), wound care and wound care to keep it moist (moist), handling of infections, debridemen, revascularization and elective surgery, prophylactic , curative, or emergency.
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