1. Dr.Suleiman Jastaniah FRCS (Ed),FACS, Trauma Fellowship(Toronto university) Associated Prof. College of Medicine

2. Diabetic foot : Definition Causes Clinical Presentation Examination Investigations Management Prevention

3. The most Frequent underlying causes : 1) Trauma 2) Neuropathy 3) Deformity 4) Peripheral arterial diseases

4. Clinical presentation : Important points in the history : o Duration o Trauma o Discharge o Fever o Loss of sensation o Diabetic status

5. Examination : General : Local : Site Size Shape Edge Floor Base Surrounding tissues – color - Temperature Pulses Sensations Lymph nodes

8. Signs of infection : pus discharge crepitus fluctuation deep tenderness Red foot------------------ cellulitis Pale or cyanotic------- ischemia Pink foot associated with pain----- severe ischemia Pulses are weak in ischemic limb and strong in neuropathic limb

9. Investigations : CBC Chemistry RBS Urine for sugar and acetone Plain X-Ray Chest X-ray ECG Duplux ultrasound

10. Management : Management of foot ulcer is determined by its severity, vascularity, and the presence of infection. It requires : 1) Knowledge of the major risk factors for amputation 2)Frequent routine evaluation 3) Meticulous preventive maintenance

11. Management : General : Local : Debridement Treat the infection Improve the ischemia

13. Management Program : Prevention Education Regular foot examinations -Come to the clinic if you notice : swelling Color changes Thick hard skin or corn Cracks or blisters Aggressive intervention Optimal use of therapeutic foot wear

14. Some preventive measures : Do : Wash feet daily with mild soap and warm water Check feet daily Seek urgent treatment of any problems Wear a sensible shoes Do not : Use a corn cutters use a hot water bottles Walk bare foot Treat foot problems yourself

15. أفراد الفريق الطبي الذين يشتركون في العناية بالقدم السكري : الطبيب الأساسي الممرضة المدربة المثقفة اختصاصي العصبية جراح الأوعية الدموية جراح العظام أخصائى العلاج الطبيعي ممرضه للعناية المنزلية مشرف اجتماعي