Diabetic foot. Update in diagnosis and treatment. Literature review

Abstract

The diabetic foot (PD) represents one of the chronic complications of diabetic disease, which occurs due to structural and functional alterations of the foot, causing, among others, diabetic foot ulcers (DFU). Mortality rates associated with the development of a DFU are estimated at 5 % in the first year, and 42 % at five years. A potentially preventable initiating event can often be identified, such as minor trauma causing a skin lesion. The classic presentation of DFU is that of a severely infected foot through a previous wound, with rapidly progressive necrosis, necrotic tissue and purulent collections are observed. Foot amputations, many of which can be prevented with early recognition and treatment, may be required in up to 20 % of diabetic foot ulcers. Routine screening for neuropathic and vascular involvement of the lower extremities and careful inspection of the feet can substantially reduce the morbidity of foot problems. Effective treatment of DFUs is complex and requires considerable expenditure of resources and significant cost to the health care system. This review provides a description of the pathophysiology, epidemiology, clinical presentation, diagnosis, and treatment of DFU.