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Lower limb amputations caused by skin changes

Lower limb amputations are a common complication in diabetes. Now, researchers from the University of Bristol in the UK have discovered why patients develop a condition which leads to amputation of the lower limbs. They say it is caused by an alteration in the skin tissue before leg ulcer develops.

In the study, 14 patients with diabetes who had had an amputation were studied. The skin tissue from their two legs – the leg with the amputation below the knee and the healthy leg – were compared. It was found that there have been changes in the connective tissue that supports the skin of the leg with the amputation below the knee. The connective tissue was being renewed at a much faster rate leading to abnormal collagen. And since the skin is weaker, it was breaking down faster, which allows ulcers to form easily.

A person with type 2 diabetes may develop an ulcer in the lower limbs which does not heal. Eventually, the condition gets worse so that the only effective treatment is to amputate below the knee. Experts say that the best way to prevent an ulcer complication is to lower the patient’s blood pressure, glucose and cholesterol. However, the problem is often undetected in its early stages.

Consequently, effective treatment can also be delayed. Among people with diabetes, approximately 15 percent of those with a foot ulcer will need to be amputated. Those with type 2 diabetes are at the most risk of developing skin ulcers that often lead to limb loss. The researchers hope that the study could make it easier to find ways of offering treatments to prevent ulcers from developing in the first place.They also hope that knowing what happens in the tissue could help doctors develop treatments to prevent ulcers from developing to help patients avoid amputations.

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