Diabetic foot syndrome

Abstract

The diabetic foot syndrome encompasses a spectrum of presentations ranging from an uninfected neuropathic ulcer to a swollen infected gangrenous foot with limb and life threat. The pathogenesis comprises a complex interplay of neuropathy, ischaemia and infection coupled with impaired host defence mechanisms in the diabetic. The misconception that ischaemia is due to untreatable, occlusive microvascular disease has generated a nilhistic attitude and bred the assumption that major amputation with resultant limb loss is always the eventual outcome. Arterial bypass procedures can restore pulsatile blood flow and together with meticulous foot care and aggressive surgical control of sepsis can salvage the limb that would otherwise have been lost.