Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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Foot injuries caused by firearms and high pressure washing machines are not common, but due to high energy can be very destructive and contaminated with microorganisms. Due to the anatomical specificity of the foot, injures of the specific structure such as blood vessels, nerves and tendon-ligament apparatus are frequent. ⋯ Functional and aesthetic recovery of the foot is a challenge for the surgeon. Direct and indirect effect of the negative pressure therapy helps in wound healing and provides good preparation for definitive surgical management of wounds.
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Diabetic foot (DF) is the most common chronic complication, which depends mostly on the duration and successful treatment of diabetes mellitus. Based on epidemiological studies, it is estimated that 25% of persons with diabetes mellitus (PwDM) will develop the problems with DF during lifetime, while 5% do 15% will be treated for foot or leg amputation. The treatment is prolonged and expensive, while the results are uncertain. ⋯ At the end, the decision for the level of amputation has to be made. Charcot neuroarthropathy is still not clearly defined, so the randomized controlled trials are rare; thus, there are many new ways of treatment but the basics belongs to off-loading in simple changes through surgical treatment in more complex changes (EBM-IV/C)(rbn1). All available methods for detecting the level of vascularization, angioplasties, and oxymetry have to be used to decide on the minimal level of amputation.