Serious lower extremity complications from diabetes include foot ulcers, infections, peripheral vascular disease, lower extremity amputations, and Charcot osteoarthropathy of the foot. 15% of people with diabetes will develop foot ulcers in their lifetime. The causes of diabetic foot ulcers are often multifaceted, among which diabetic neuropathy, ischemic lesions or neuro-ischemic lesions are the most important factors causing ulceration.

The mechanism of foot ulcers in diabetic patients is very complex. It is the result of the combined action of many intrinsic and extrinsic factors. Intrinsic risk factors include: nerve and vascular disease, immune factors (susceptibility to infection), foot deformity, joint activity Restriction, kidney disease, age, duration of diabetes, visual impairment, and history of ulcers; external factors include: increased plantar pressure, biomechanical microtrauma caused by shoe compression, navel suit, temperature-induced injury, podiatrist mishandling, occupational injury, chemical burns, living alone, smoking, lack of knowledge about diabetes, psychological problems, etc. The complexity of pathogenesis determines the specificity of clinical manifestations. The healing process of foot ulcers is different from that of general ulcers, and is also affected by the cross-influence of many of the above-mentioned internal and external factors, so the treatment and treatment will be very difficult. A correct understanding of the role of various factors in the occurrence of diabetic foot ulcers is of great significance for guiding ulcer treatment, promoting wound healing and preventing the occurrence of foot ulcers.

At present, the generally accepted view on the pathogenesis of diabetic foot ulcer is the ternary theory of diabetic foot: namely, the three most important risk factors of diabetic neuropathy, diabetic ischemic lesions and local infection are the basis, and the external minor trauma is the basis. Triggers can promote the formation and progression of ulcers.

Emphasize the four irreplaceable important alginate dressing links in wound management: local decompression; thorough debridement; control of infection; improvement of ischemia.

It should be remembered that when treating ulcers, it is important to choose those drugs that have been proven to be effective in randomized controlled studies. In 1934, the famous diabetes scholar Elliott P.joslin said: "We should firmly believe that ulcer necrosis in diabetes is not caused by birth, but caused by human factors."

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