Un mal perforant plantaire est une atteinte du pied caractérisée par une ulcération de la face plantaire, dont le caractère indolore favorise l'aggravation. Dans le cas du diabète, « il témoigne de l’ancienneté du diabète et souvent du mauvais contrôle glycémique » et nécessite une prise en charge appropriée et si nécessaire multidisciplinaire.↑ Clavel, S. (2010). Prendre en charge un mal perforant plantaire diabétique.

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  • Un mal perforant plantaire est une atteinte du pied caractérisée par une ulcération de la face plantaire, dont le caractère indolore favorise l'aggravation. Dans le cas du diabète, « il témoigne de l’ancienneté du diabète et souvent du mauvais contrôle glycémique » et nécessite une prise en charge appropriée et si nécessaire multidisciplinaire.
  • Con ulcera diabetica si intende una lesione di continuo di difficile guarigione spontanea che può interessare, in relazione alla sua importanza e gravità, i tessuti cutanei, sottocutanei ed ossei. La sua localizzazione distrettuale più comune è nel piede coinvolgendo in senso disto-prossimale le regioni apicali delle dita, le giunture articolare delle interfalangee, le teste metatarsali (regione plantare), il tallone, le prominenze ossee del mortaio tibio-peroneo-astragalico (caviglia), e la gamba. Il coinvolgimento del piede è molto pericoloso per il protrarsi della patologia in quanto spesso si presentano coinvolgimenti dei tessuti sottocutanei ed ossei con infezioni e fistole che possono far sviluppare necrosi settica e relativa amputazione della regione interessata, anche se la ricerca e la tecnologia consentono la realizzazione del trapianto dei tessuti.
  • Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. Major increase in mortality among diabetic patients, observed over the past 20 years is considered to be due to the development of macro and micro vascular complications, including failure of the wound healing process.[citation needed] 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. Controlled and accurate rebuilding is essential to avoid under- or over-healing that may lead to various abnormalities. 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 histopathological 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.Non-healing chronic diabetic ulcers are often treated with extracellular matrix replacement therapy. So far, it is a common trend in diabetic foot care domain to use advanced moist wound therapy, bio-engineered tissue or skin substitute, growth factors and negative pressure wound therapy. No therapy is completely perfect as each type suffers from its own disadvantages.Moist wound therapy is known to promote fibroblast and keratinocyte proliferation and migration, collagen synthesis, early angiogenesis and wound contraction. At present, there are various categories of moist dressings available such as adhesive backing film, silicone coated foam, hydrogels, hydrocolloids etc. Unfortunately, all moist dressings cause fluid retention; most of them require secondary dressing and hence are not the best choice for exudative wounds. To address the physiological deficiencies underlying diabetic ulcer, various tissue engineering technologies have come up with cellular as well as acellular skin replacement products. New therapies in development are also promising, such as platelet rich fibrin wound patch therapy, which is often simpler and proving effective in chronic diabetic foot ulcers.
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  • Un mal perforant plantaire est une atteinte du pied caractérisée par une ulcération de la face plantaire, dont le caractère indolore favorise l'aggravation. Dans le cas du diabète, « il témoigne de l’ancienneté du diabète et souvent du mauvais contrôle glycémique » et nécessite une prise en charge appropriée et si nécessaire multidisciplinaire.↑ Clavel, S. (2010). Prendre en charge un mal perforant plantaire diabétique.
  • Con ulcera diabetica si intende una lesione di continuo di difficile guarigione spontanea che può interessare, in relazione alla sua importanza e gravità, i tessuti cutanei, sottocutanei ed ossei.
  • Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations.
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  • Mal perforant plantaire
  • Diabetic foot ulcer
  • Ulcera diabetica
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