| Autor: |
Cavanagh, Peter R., Ulbrecht, Jan S., Caputo, Gregory M. |
| Zdroj: |
Foot in Diabetes; 2000 3rd Edition, p33-59, 27p |
| Abstrakt: |
Many diabetic foot ulcers fail to heal because of simple biomechanical issues that are not covered during medical training. When the body is supported by a single limb during walking, the total force under the foot is approximately 110% of body weight. Bony prominences may experience far greater concentrations of load, often not noticed because of peripheral neuropathy. Certain foot structures predispose an individual to higher pressures and callus concentrates pressure. Footwear is the most important extrinsic determinant of elevated pressure: shoes often fit incorrectly and fail to provide adequate cushioning. Prevention of foot pathology starts with identification of patients with neuropathy or ischaemia: procedures for foot examination are described. The gold standard for healing neuropathic ulcers is the total contact cast, in combination with good wound care, but the cast requires specialist staff. The critical requirement is compliance with non-weight-bearing and the patient needs to understand the rationale for this. The importance of footwear is discussed with practical advice on choosing the simplest effective solution. [ABSTRACT FROM PUBLISHER] |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
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