6700 Kirkville Rd. Suite 202

East Syracuse, NY 13057

(315) 701-2929
OVERVIEW

Diabetes exerts a significant influence on American society. Approximately 21 million people, comprising 7% of the U.S. population is estimated to have diabetes. Of the U.S. diabetic population, it is estimated that 15% will develop manifestations of diabetic foot disease in their lifetime. Development of diabetic foot disease can be attributed to several primary risk factors including neuropathy, ischemia, infection, and immune impairment.

Neuropathy alters motor, sensory, and autonomic function, which directly affects the dynamic function of the foot during gait. Anhydrotic tissues, intrinsic muscle atrophy, and resulting foot deformities, cause abnormal plantar pressures in a foot with inadequate protective sensation. The detrimental effects of ghlycosilation of collagen also increase plantar pleasures. The results in tight skin and restriction of joint mobility as well as equines deformities secondary to glycosilation of the Achilles tendon.

One of the major factors affecting diabetic foot disease is the development of lower-extremity arterial disease. Peripheral vascular disease is estimated to be 20 times more common in diabetics then nodiabetics. Decrease in arterial perfusion of the lower extremity has many effects, including claudication, an increase in the risk of diabetic foot infection, foot ulceration, poor wound healing, gangrene and amputation.

In the presence of the above risk factors, including immunologic impairment, it is common for undiagnosed clean neuropathic foot ulcers to convert to acute infections with abscess and/or cellulites.


TREATMENT

In order to accurately diagnose and treat neuropathic foot ulcers, one must be able to comprehend the biomechanical issues, which affect foot function. Abnormal mechanical forces that can result in ulcerations should be addressed with the use of offloading devices in order to assist in wound healing.

Reconstructive foot surgery may often become the conservation treatment in order to avoid major amputation, maintain skin integrity, and improve function.


GOALS

The population affected by diabetic foot disease represents a significant portion of the diabetic community. These patients require special attention in attempt to limit morbidity and extend limb life. This includes patient education and frequent inspection of the neuropathic foot. Careful assessment of vascular disease, evaluation and management of biomechanical abnormalities, and aggressive treatment of infections are required to affect the natural history of this disease. With Dr. Dutch’s specialized training and the utilization of a multi disciplinary approach, diabetic limb-salvage with long-term viability of the lower extremity can be achieved.

We provide special attention to patients in attempts to limit morbidity and extend limb life. This includes patient education and frequent inspection of the neuropathic foot.

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