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Diabetic Foot: Surgical Principles and Practices
G Sivakumar
CHAPTER 1:
Introduction
CHAPTER 2:
Foot Problems in Diabetics—A Historic Perspective
CHAPTER 3:
Epidemiology
CHAPTER 4:
Surgical Anatomy of the Foot
ARTERIES AND VEINS OF THE FOOT
Intrinsic Muscles
CHAPTER 5:
Aetiopathogenesis of Foot Changes in Diabetes
SEQUENCE OF DEVELOPMENT
MAJOR FACTORS
MINOR FACTORS
CHAPTER 6:
Diabetic Neuropathy
ACUTE SENSORY NEUROPATHY
NEUROPATHY—CHANGES IN THE NERVES
PKC
CHAPTER 7:
Peripheral Arterial Disease in People with Diabetes
DIABETIC MACROANGIOPATHY
Diabetes and Endothelial Cell Dysfunction
Diabetes and the VSMC
Diabetes and the Platelet
Diabetes, Coagulation and Rheology
Critical Leg Ischaemia
CHAPTER 8:
Microvascular Changes in the Foot of the Diabetics
ENDOTHELIAL FUNCTION
CHAPTER 9:
Role of Infection in Diabetic Foot
PATHOPHYSIOLOGY OF INFECTION
MICROBIOLOGY
CHAPTER 10:
Gait Analysis and Biomechanics
CHAPTER 11:
Clinical Presentation of Diabetic Foot Lesions
THE ACUTE FOOT GROUP
THE CORN GROUP
THE BLACK TOE GROUP
THE BANDAGER GROUP (Figs 11.8 and 11.9)
The Paraesthesia Group
Clawed Foot Group (Figs 11.10 and 11.11)
The Charcot Joint Group (Fig. 11.12)
The Diabetic Skin Group (Figs 11.13 and 11.14)
The Nail Infection Group
The Claudicator Group
The Painful Foot Group (Fig. 11.15)
The Ankle Oedema Group
Non-neuropathic Architectural Deformities
CHAPTER 12:
Clinical Assessment of Neuropathy
CLINICAL TESTS TO DETECT NEUROPATHY
SEMMES-WEINSTEIN MONOFILAMENTS (Fig. 12.2)
VIBRATION PERCEPTION
CHAPTER 13:
Clinical Assessment of Foot for Vascular Disease
CHAPTER 14:
Clinical Diagnosis of Infection Complicating Diabetic Foot
CHAPTER 15:
Diagnosis of Osteomyelitis of Foot
CHAPTER 16:
Foot Ulcers and their Management
NONHEALING ULCERS DUE TO DEFECTIVE WOUND HEALING
CHAPTER 17:
Investigations
BACTERIAL CULTURE
X-RAY FOOT
DUPLEX ULTRASOUND
CT SCAN AND MR IMAGING
ARTERIOGRAPHY
SCINTIGRAPHY
Pedobarography and Gait Analysis
Transcutaneous Oximetry
CHAPTER 18:
Plantar Pressure and Development of Foot Pressure
CHAPTER 19:
Classification of Diabetic Foot Lesions
CHAPTER 20:
Management Principles
ACUTE PRESENTATION
Whether the patient needs admission?
Is it life-threatening?
Is it limb-threatening? What is the extent of ischaemia?
Is sepsis the cause for clinical presentation?
Whether emergency surgery required?
What is the diabetic status, ketosis present?
What is the degree of co-morbid illness of major organs
Chronic Presentation
CHAPTER 21:
Preventive Strategies
COMMUNITY FOOT CARE PROGRAMMES AND FOOT EDUCATION
Put Feet First: Prevent Amputations
CHAPTER 22:
Wound Healing in Diabetes
DECREASE IN WOUND BACTERIAL CONTAMINATION
DRAINAGE
DEBRIDEMENT
INDOLENT NONHEALING WOUND
1. Collagen Sheets, Powders
2. Phenytoin Powder
3. Silver Dressing
4. Living Human Skin Equivalent
5. Growth Factors
Role of Growth Factors
Novel Therapies
CHAPTER 23:
Sepsis Management
CHAPTER 24:
Vascular Surgical Management of Diabetic Foot Disease
SURGICAL PROCEDURE (Fig. 24.3)
CHAPTER 25:
Medical Management of Diabetic Neuropathy
CHAPTER 26:
Charcot's Arthropathy and Off-loading Principles
PRINCIPLES OF OFF LOADING
CHAPTER 27:
Skin Cover
CHAPTER 28:
Foot Care for Diabetics
HOW SHOULD THE DIABETICS TAKE CARE OF THE FOOT?
CHAPTER 29:
Therapeutic Footwear for Diabetics
SUGGESTIONS10 FOR ASSESSING AND SELECTING SHOES AND SOCKS
Shoes
Socks
Parameters used in designing a therapeutic shoe
CHAPTER 30:
Amputations in Diabetic Foot Disease
IDENTIFICATION OF RISK GROUPS
DESCRIPTION OF VARIOUS AMPUTATIONS
CHAPTER 31:
Foot and Co-morbid Illness in Diabetics
FOOT AND CO-MORBID ILLNESS IN DIABETICS (Table 31.1)
1. Metabolic Dysfunction
2. Cardiovascular Disease
3. Neurological Disease
4. Renal Dysfunction (Fig. 31.1)
5. Hepatic Disease
6. Haematological Disease
7. Retinopathy
INDEX
TOC
Index
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