01312nas a2200229   4500000000100000008004100001260001300042653002700055653000900082653001800091653001100109653001200120653001400132653001500146100001400161700001500175245009100190300001000281490000800291520076900299022001401068       1990                            d  c1990 Dec10aDiabetes Complications10aFoot10aFoot Diseases10aHumans10aleprosy10aSensation10aSkin Ulcer1 aDuffy J C1 aPatout C A00aManagement of the insensitive foot in diabetes: lessons learned from Hansen's disease.  a575-90 v1553 a<p>Diabetes mellitus is the number one cause of lower extremity amputation (LEA) in the United States, accounting for about 60,000 cases per year. While the combination of reduced blood supply and the loss of sensation to the foot in a diabetic are responsible for the high incidence of LEAs, in most cases it is the loss of sensation that is primarily responsible for the initial foot wound and its failure to heal. The authors review the four mechanical causes for foot ulceration and eventual amputation. Based on an understanding of how feet ulcerate, the National Foot Treatment Center in Carville, LA has developed an insensitive foot screening and treatment program for "diabetic" foot ulcers that is more than 90% effective in healing plantar ulcers.</p>
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