Sosyo
Online ISSN : 1884-880X
ISSN-L : 1884-880X
Feature Articles 1 : Evaluation of wound state and selection of treatment methods - pros and cons -
Diagnosis and Treatment of Diabetic Foot Ulcers;Ischemic Ulcer and Neuropathic Ulcer
Ichiro HashimotoAtsushi MorimotoYoshiro AbeHideki Nakanishi
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2013 Volume 4 Issue 1 Pages 9-15

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Abstract

Leg and foot are known as regions with relatively poor blood circulation. Diabetic foot ulcers have complex causes and are difficult to heal. Because recovery from a diabetic foot ulcer is thought to be very difficult, amputation below or above the knee is sometimes selected. The main etiologies of diabetic foot ulcer are divided into three categories : neuropathic (45%), neuroischemic (24%), and ischemic ulcers (16%). Finding the main etiology of a diabetic ulcer is very important and the first thing to be done before treatment. When the foot ulcer is due to ischemia, the obstructed portion in the artery should be found. Revascularization by surgical bypass procedure or percutaneous transluminal angioplasty can be performed for good healing of the ulcer. When the patient has a neuropathic DM ulcer that does not show significant arterial disease, free flap transfer after debridement can be performed using side-to-end or flow-through arterial anastomosis to avoid amputation of the limb. Microsurgical flap transplantation was useful for minimum amputation of diabetic foot in our experience. Postoperatively, attention has to be paid to neuropathy in these patients because the causes of their foot ulcers include sensory and motor disturbances.

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© 2013 Japan Society for Surgical Wound Care
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