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Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot. Wound healing is an innate mechanism of action that works reliably most of the time. A key feature of wound healing is stepwise repair of lost extracellular matrix (ECM) that forms the largest component of the dermal skin layer.〔Iakovos N Nomikos et al, Protective and Damaging Aspects of Healing: A Review, ''Wounds'' 2006; 18 (7) 177-185.()〕 But in some cases, certain disorders or physiological insult disturbs the wound healing process. Diabetes mellitus is one such metabolic disorder that impedes the normal steps of the wound healing process. Many studies show a prolonged inflammatory phase in diabetic wounds, which causes a delay in the formation of mature granulation tissue and a parallel reduction in wound tensile strength.〔McLennan S et al, Molecular aspects of wound healing, Primary intention(2006).14(1) 8-13 ()〕 Treatment of diabetic foot ulcers should include: blood sugar control, removing dead tissue from the wound, dressings, and removing pressure from the wound through techniques such as total contact casting. Surgery in some cases may improve outcomes.〔 Hyperbaric oxygen therapy may also help but is expensive.〔 It occurs in 15% of people with diabetes and precedes 84% of all diabetes-related lower-leg amputations. == Risk factors == Risk factors implicated in the development of diabetic foot ulcers are diabetic neuropathy, peripheral vascular disease, cigarette smoking, poor glycemic control, previous foot ulcerations or amputations, diabetic nephropathy, and ischemia of small and large blood vessels. Diabetic patients often suffer from diabetic neuropathy due to several metabolic and neurovascular factors. Peripheral neuropathy causes loss of pain or feeling in the toes, feet, legs and arms due to distal nerve damage and low blood flow. Blisters and sores appear on numb areas of the feet and legs such as metatarso-phalangeal joints, heel region and as a result pressure or injury goes unnoticed and eventually become portal of entry for bacteria and infection. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「diabetic foot ulcer」の詳細全文を読む スポンサード リンク
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