Diabetic foot on board!
Let’s talk diabetes, a disorder with a hundred faces and a thousand complications.
This image shows an extensive diabetic foot ulcer that was neglected and acquired an infection later on.
Diabetic foot ulcers occur as a result of various factors, such as mechanical changes in conformation of the bony architecture of the foot, peripheral neuropathy, and atherosclerotic peripheral arterial disease.
The mechanism involves a non-enzymatic glycation that predisposes ligaments to stiffness and neuropathy that causes loss of protective sensation and loss of coordination of muscle groups in the foot and leg, both of which increase mechanical stresses during ambulation.
The result of loss of sensation in the foot is repetitive stress, unnoticed injuries, fractures, heat, cold, or even unnoticed damage from a blunt or sharp object, structural foot deformities, and eventual tissue breakdown that cause blistering and ulceration.
In this case, local trauma and/or pressure (often in association with lack of sensation because of neuropathy), in addition to microvascular disease, have lead to a diabetic foot infection following an untreated ulceration.
These factors, combined with poor arterial inflow, confer a high risk of limb loss on the patient with diabetes.