Pathophysiology of Ulcer Right Great
Toe
Risk factors are previous lower extremity amputation ,history of
a foot ulcer ,peripheral vascular disease , poor glycemic control ,
smoking etc
- These risk factors produces oxidative stress on nerve cells and
leads to neuropathy.
- Additional nerve dysfunction follows from the glycosylation of
nerve cell proteins, leading to further ischemia.
- Those cellular changes manifest in motor, autonomic, and
sensory components of neuropathic foot ulcers.
- Damage to motor neurons of foot musculature may lead to an
imbalance of flexors and extensors, anatomic deformities, and
eventual skin ulcerations.
- Damage to autonomic nerves impairs sweat gland function, and
foot may develop decreased ability to moisturize skin, leading to
epidermal cracks and skin breakdown.
- Then the patients may not notice foot wounds because of
decreased peripheral sensation.
- Because of blood supply required to heal a diabetic foot ulcer
is greater than that needed to maintain intact skin, chronic
ulceration can develop.