Diabetic ulcer pathogenesis

March 4th, 2010 | Posted in Medical, Nursing articles

Diabetic ulcer pathogenesis
Cause of diabetic foot ulcers is multifaktorial.

Factors that could cause categories into 3 groups, namely due to pathophysiological changes, deformity
anatomy and environmental factors.

Pathophysiological changes at the biomolecular level causes of peripheral neuropathy, peripheral vascular disease and decreased immune system resulting in disruption of the wound healing process.
Deformities of the foot as it occurs in Charcot neuroartropati occur as a result of motor neuropathy.
Environmental factors, particularly the acute or chronic trauma (due to pressure of shoes, sharp objects, etc.)
is a factor that started the ulcer.

Peripheral neuropathy in DM disease can cause damage to the motor fibers, sensory and autonomic.
Damage to motor fibers can cause muscle weakness, muscle atrophy, deformity (hammer toes, Claw toes, pes cavus, pes Planus, halgus valgus, Achilles tendon contractures) and together with the ease of neuropathy
callus formation. Damage to sensory fibers that results from damage to myelin fibers resulted in decreased pain sensation that facilitate the occurrence of foot ulcers.
Autonomic fiber damage that occurs due to sympathetic denervasi cause dry skin (anhidrosis) and
fissure formation of the skin and leg edema. Damage to motor fibers, sensory and autonomic facilitate the occurrence
artropati Charcot. Good peripheral vascular disorders due makrovaskular (atherosclerosis) or due to interference
which is causing mikrovaskular leg ischemia. The situation is in addition to being
cause of the ulcer healing process is also complicated leg ulcers.

For practical clinical purposes, diabetika feet can be divided into 3 categories, namely

* Diabetika foot neuropathy,
* Ischemia
* Neuroiskemia.

In general, legs caused by factors diabetika neuropathy (82%) the rest is due to purely due neuroiskemia and ischemia.

Assessment of Diabetic Foot ulcer
Leg ulcer assessment is essential because decisions related to the therapy.
Ulcer assessment begins with anamnesis and physical examination and investigation.

Anamnesis daily activities, used shoes, callus formation, foot deformity, complaints neuropathy, leg pain during activity, duration of suffering from DM, komorbid disease, habits (smoking, alcohol), drugs that are consumed, suffer from a history of ulcer / amputation before.

Physical examination is directed to a description of ulcer characteristics, determine the presence or absence of infection, determining the background of ulcers (neuropathy, peripheral vascular obstruction,
trauma or deformity), the classification of ulcers and neuromuscular examination to determine a /
whether the deformities.

Share on Facebook