Review Article
Year: 2020 | Month: January | Volume: 10 | Issue: 1 | Pages: 24-27
Physiatrist’s Management of Diabetic Foot Ulcer
V. Ramamoorthy
Professor and Head, Department of Physical Medicine and Rehabilitation, PSG IMS&R Hospitals, Coimbatore, Tamilnadu.
ABSTRACT
Diabetes is a metabolic disease that affects multiple systems. Even within the nervous system the manifestations of this disease can be wide and varied. Foot disorders are a main source of morbidity and a leading cause of hospitalization for person with diabetes mellitus. Ulceration, infection, gangrene and amputation are significant complications of diabetes. Although not all foot complications can be prevented, dramatic reductions in their frequency have been obtained through the implementation of multidisciplinary team approach to patient management. The objectives of diagnosis and treatment of diabetic foot sequelae center around maintaining the patient as an ambulatory, productive member of society or returning the patient to that state as quickly and safely as possible. This may at any time require the expertise of a number of different specialists on the diabetic foot care team and a Physiatrist is one among them. The physiatrist by virtue of his or her training is uniquely suited to serve as a primary member of a multidisciplinary team for the management of diabetic foot disorders and able to recognize impending diabetic foot complications. Total Contact Cast is considered the Gold standard to assist healing for active diabetic ulcerations by providing weight (pressure) redistribution and friction/shear control. Multiple randomized controlled clinical studies have been conducted which illustrate that the majority of diabetic foot ulcers heal with the use of TCC in a mean time of 35-52 days for 85-95% of patients.
Key words: Diabetes mellitus, Diabetic Ulcer, Total contact cast