Diabetic Foot Care

Acknowledgements ix Introduction xi 1 Neuropathic Case Studies 1 1.1 Introduction 1 1.2 Differing presentations of infection and complications of infection 3 1.3 Co-morbidities in addition to diabetes and neuropathy 36 1.4 Deformity, ulceration and infection treated by surgical debridement and reconstruction 40 1.5 Patients with neuropathic feet in whom psychological factors have impacted on their management 48 1.6 Long term patients followed in the Diabetic Foot Clinic with neuropathic foot problems 57 2 Ischaemic Case Studies 83 2.1 Introduction 83 2.2 Infection and its presentations 86 2.3 Patients with severe co-morbidities 92 2.4 Revascularisation 105 2.5 Wound care 135 2.6 Emboli 140 2.7 Complications 144 2.8 Pain in the neuroischaemic foot 151 2.9 Conservative care 153 3 Charcot Case Studies 157 3.1 Introduction 157 3.2 Early diagnosis 160 3.3 Different presentations 172 3.4 Surgery 195 3.5 Conservative care 214 4 Renal Case Studies 217 4.1 Introduction 217 4.2 Patients with normal serum creatinine who develop low creatinine clearance with infection 219 4.3 Low creatinine clearance and complications 225 4.4 Continuous ambulatory peritoneal dialysis (CAPD) and complications 238 4.5 Haemodialysis and complications 246 4.6 Renal transplant and complications 250 4.7 Revascularisation in renal patients 255 Index 261