1. DIABETIC RELATED INFECTION AND MANAGEMENT

7. Polyol pathway Glucose Sorbitol Fructose NADPH + H + NADP + NAD + NADH + H + Aldose reductase Polyol dehydrogenase

16. SOFT TISSUE INFECTION

27. NF at presentation rapid progression seen after 24hours

36. MANAGEMENT PREVENTION IS BATTER THAN CURE

40. Ischaemia VS Neuropathy Ischaemia Neuropathy Symptoms Claudication Rest pain Usually painless Or painful neuropathy Inspection Dependent rubor Trophic changes High arch + clawing of toes Present or No trophic changes Palpation Cold Pulseless Warm Bounding pulses Ulceration Painful Heels and toes Painless Plantar

41. Ischemic foot ulcer Dorsum of 2 nd toe shows ischaemic lesion. Whitish color on the tip d/t ischaemia

42. Neuropathic foot ulcer Ulcer on the 1 st metatarsal head. Health granulation tissue on its bed. Callus formation on its surrounding ulcer lesion.

43. Mixed etiology (Neuro-ischemic) ulcer

44. Gangrene Death of tissue usually in considerable mass Generally d/t loss of vascular supply & followed by bacterial infection

55. Table Depth Classification Definition Treatment 0 At-risk foot, no ulceration Patient education, accommodative footwear, regular clinical examination 1 Superficial ulceration, not infected Offloading with total contact cast (TCC), walking brace, or special footwear 2 Deep ulceration exposing tendons or joints Surgical debridement, wound care, offloading, culture-specific antibiotics 3 Extensive ulceration or abscess Debridement or partial amputation, offloading, culture-specific antibiotics Ischemia Classification A Not ischemic B Ischemia without gangrene Noninvasive vascular testing, vascular consultation if symptomatic C Partial (forefoot) gangrene Vascular consultation D Complete foot gangrene Major extremity amputation, vascular consultation