In diabetic patients, the dryness of the feet caused by the impairment of the sweating mechanism due to autonomic neuropathy causes cracks, crevices and calluses on the skin. These cracks and crevices are entry points for fungi and other infectious agents. Infection causes cracks to grow and deepen. As a result of diabetes-related damage to sensory nerves (diabetic sensory neuropathy), the patient does not feel the infected wound and pain on his foot. As the wound grows and the infection increases, and by the time the patient becomes aware of the wound with the discharge, the wound has already become threatening to the foot and leg. As a result of vascular damage due to diabetes, wound healing is delayed due to insufficient blood supply to the foot.
There are stages of diabetic wound. Diabetic foot stages are listed as follows according to the Wagner Classification:
Stage 0: Healthy skin
Stage 1: Superficial ulcer
Stage 2: Deep ulcer
Stage 3: Ulcer with bone involvement
Stage 4: Forefoot (fingers/toe) gangrene
Stage 5: Gangrene of the entire foot