الفهرس 
ANATOMY OF THE FOOTOnly 14 pages are availabe for public view
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Abstract
lceration, infection, gangrene, and lower extremity amputation are complications often encountered in patients with diabetes mellitus. These complications frequently result in extensive morbidity, repeated hospitalizations, and mortality. They take a tremendous toll on the patient’s physical and mental well-being as well as impose a substantial economic burden, often removing the patient from the workforce and placing a financial drain on the health care system.
According to a recent study, the mean annual cost of treating an uninfected ulcer was $9,306, while the cost of treating an ulcer with osteomyelitis exceeded $45,000.
Not all diabetic foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention programs. The multidisciplinary team approach to diabetic foot disorders has been demonstrated as the optimal method to achieve favorable rates of limb salvage in the high-risk diabetic patient.
Foot care programs emphasizing preventive management can reduce the incidence of foot ulceration through modification of self-care practices, appropriate evaluation of risk factors, and formulation of treatment protocols aimed at early intervention, limb preservation, and prevention of new lesions.
A significant reduction in both major and minor diabetic limb amputations is certainly attainable if clinicians embrace these principles and incorporate them into daily patient care.
Diabetic foot infections remain a challenge, and outcomes are often poor. The best outcomes, and possible avoidance of amputation, are achieved using a multidisciplinary approach.
This includes determining the microbial etiology and using appropriate antibiotics, attentive wound care, surgical debridement and consideration of adjunctive measures such as HBOT…
When conservative and noninvasive treatment measures fail to resolve foot infections, surgical intervention is required.
The role of surgery in diabetic foot disease is focused on the management of soft tissue infection and necrosis.
The aim of surgery is to minimize tissue loss and preserve foot function. Early debridement of dead and infected tissue may prevent loss of the foot.
Major limb amputation is only indicated when destruction is too extensive to permit salvage of a useful foot, or where prolonged attempts at foot salvage are inappropriate.