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Diabetic foot

DM foot: silent killer

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Diabetic foot

  1. 1. DIABETIC FOOT: SILENT KILLER FACEBOOK: HAPPY FRIDAY KNIGHT PATIENT CARE TEAM: SURGERY 13TH NOV 2020
  2. 2. OUTLINES • DEFINITION • EPIDEMIOLOGY • PATHOPHYSIOLOGY • HISTORY TAKING, PHYSICAL EXAMINATION, AND INVESTIGATION • CLASSIFICATION • MANAGEMENT
  3. 3. DEFINITION • DIABETIC FOOT: SIGNS AND SYMPTOMS FROM • NEUROPATHY • ISCHEMIA • INFECTION
  4. 4. EPIDEMIOLOGY • COMPLICATIONS FROM DF RESULTS IN HIGH MORBIDITY AND MORTALITY: LIMB LOSS AND DEATH • 70% OF MAJOR AMPUTATION ARE FROM DF • 50% DEATH AFTER AMPUTATION: FROM ATHEROSCLEROTIC DISEASE
  5. 5. PATHOPHYSIOLOGY • MULTIFACTORIAL • NEUROPATHY • VASCULAR INSUFFICIENCY • INFECTION • MUSCLE AND BONE DEFORMITIES
  6. 6. https://www.healthline.com/health/charcot-foot#pictures
  7. 7. HISTORY TAKING GENERAL MEDICAL HISTORY • FAMILY HISTORY OF DM • OCCUPATIONAL NEEDS • ATHEROSCLEROTIC DISEASE AND OTHER COMORBIDITIES • NUTRITIONAL STATUS • SURGICAL HISTORY AND HOSPITALIZATION • GLYCEMIC MANAGEMENT • ETC FOOT-SPECIFIC HISTORY • FOOT HISTORY: DISEASE, FOOTWEAR, PAIN, CONTACT, DEFORMITY CLAUDICATION, PRESSURE, EDEMA • WOUND AND ULCER HISTORY • INCENTIVE • DURATION • RECURRENCE • SIZE AND LOCATION • WOUND CARE
  8. 8. PHYSICAL EXAMINATION • VASCULAR • NEUROLOGIC • DERMATOLOGIC • MUSCULOSKELETAL
  9. 9. MANAGEMENT • GENERAL MANAGEMENT OF DIABETES • RISK ASSESSMENT • FOOT MANAGEMENT • WOUND • PATIENT EDUCATION
  10. 10. GENERAL MANAGEMENT OF DIABETES • GLYCEMIC CONTROL: DIABETIC GUIDELINES • HBA1C < 6.5% • ATHEROSCLEROTIC DISEASE MANAGEMENT: STROKE, MI, DIABETIC NEPHROPATHY. DIABETIC RETINOPATHY, PERIPHERAL VASCULAR DISEASE • BLOOD PRESSURE CONTROL • SMOKING CESSATION
  11. 11. FOOT MANAGMENT • OFFLOADING: • GENERALIZE PRESSURE • MINIMIZE PRESSURE ON THE WOUND AND PREVENT RECURRING • FOOTWEAR
  12. 12. WOUND MANAGEMENT • DEBRIDEMENT OR AMPUTATION • ANTIBIOTICS IN DFI • WOUND CARE AND DRESSING
  13. 13. REFERENCES • SIDAWAY AN, PERLER BA. RUTHERFORD’S VASCULAR SURGERY AND ENDOVASCULAR SURGERY. 9TH ED. ELSEVIER: PHILADELPHIA, 2019. • WANG A, ET AL. GUILDELINES ON MULTIDISCIPLINARY APPROACHES FOR THE PREVENTION AND MANAGEMENT OF DIABETIC FOOT DISEASE (2020 EDITION). BURNS & TRAUMA. 8: 2020. • แนวทางเวชปฏิบัติ การป้องกันและดูแลรักษาผู้ป่วยเบาหวานที่มีภาวะแทรกซ้อนทีเท้า 2556

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