PPT Journal Diabetic Foot Ulcer .pptx

Diabetic Foot Ulcer

1. Diabetic foot ulcer: A comprehensive review of pathophysiology and management modalities dr. Akbar

2. Abstrac Diabetic foot ulcer (DFU)  complication of chronic uncontrolled diabetes characterized by ulceration which usually occurs in the plantar area of the foot 15% of diabetes sufferers have complications of DFU 14%-24% of them require amputatuion a foot with a bone infection

3. Introduction 442 million people suffer from diabetes in worldwide Responsible for 2 million death/year Affecting 11.3% of the American 14%-24% of them require leg amputation with bone infections such as osteomyelitis Due to the high morbidity rate, it is very important to treat the underlying cause of DFU

4. Pathophysiology Triad pathologic mechanism of DFU

5. DFU comprises a full-thickness wound involving the dermis located in the weight-bearing or exposed area below the ankle Pathophysiology Wagner system  categorizing the severity of the ulcer

6. Pathophysiology Sensory Neuropathy

7. Pathophysiology Sensory Neuropathy

8. Pathophysiology Neuronal Autonomic Dysfunction

9. Pathophysiology

10. Pathophysiology

11. Pathophysiology Substantial Alterations Of The Extracellular Matrix

12. Pathophysiology Impaired Angiogenesis

13. Management

14. Management

15. Wound dressings Human skin equivalent Hyperbaric oxygen therapy Larvae therapy (maggot therapy) 01 02 T he use of HSE resulted in 18% increase in complete wound healing 04 R esulted in significantly reduced rates of major amputation 05 E nabled faster development of granulation tissue and more significantly decreased wound surfase area The most basic and common treatment, to serve a vital purpose in DFU 03 C ommon methods  bed rest, wheelchair use, crutch-assisted gait, total contact casting, felted foam, therapeutic shoes, removable cast walkers Offloading, TCC Management Noninvasive care

16. Topical growth factors Shock wave therapy Systemic and local antibiotics Negative pressure wound therapy 06 07 ESWT is utilized to stimulate osteoblasts and in turn facilitate soft tissue healing 09 Most DFUs have a microbial cause, with aerobic Gram-positive cocci and staphylococci being the most common implicated microbe 10 Utilizes vacuum pressure to draw fluid from the wound and increase blood flow to the affected area, thus stimulating the healing process Growth factors serve as principal immediate mediators of wound healing, and accelerate ulcer healing. 08 Aid wound healing by secretion of cytokines that play an important role in cell migration, angiogenesis, remodeling of extracellular matrix, and regeneration of nerves Stem cell therapy Management Noninvasive care

17. Management Stem cell therapies available for diabetic foot treatment

18. Debridement Revascularization (angioplasty) Amputation 01 02 S tenting and surgical bypass The ulcer healing rate following revascularization ranges from 46% to 91% 04 F inal management option for the most chronic levels of infection or deformity Changing the chronic wound environment by removing necrotic and nonviable tissue 03 R eplace the infected skin and promote the healing process Skin Grafting Management Invasive Treatement Strategies

19. Thankyou