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In most cases, a deep protective sensation seems sufficient for the protection of flaps [ 29– 31].
High plantar pressures have been associated with foot ulceration in people with diabetes, who can experience loss of protective sensation due to peripheral neuropathy.
Patients with better circulation and protective sensation intact fared better.
On her last visit, the patient had pain-free ambulation without assistance, had intact protective sensation distal to the injury, and was very satisfied with the outcome.
Sensation was not further considered since all patients showed a loss of protective sensation (S2).
This leads to numbness, loss of protective sensation and an increased risk of amputation.
Similar(11)
The safety and efficacy of multi-week applications of low-concentration capsaicin creams (0.025 to 0.075% w/w) have been evaluated in six large double-blind trials with comparators and in other smaller studies with no reports relating to either loss of protective sensations or impaired wound healing.
The absence of any self-limiting factor, such as protective pain sensation, can cause a progressive course and may result in a "highly difficult to treat" status.
CONCLUSIONS The striking preservation of protective foot sensation in Alström syndrome may provide a clue to the causes of differential susceptibility to neuropathy in the wider diabetic population.
Inclusion criteria were age ≥18 years, confirmed type 1 or type 2 diabetes, loss of protective foot sensation as a result of peripheral neuropathy, a healed plantar foot ulcer (i.e., full epithelialization without exudate) in the 18 months preceding randomization, and a new prescription of custom-made footwear.
Approximately one-half of all diabetic foot ulcers occur on the plantar foot surface and are mainly caused by elevated levels of mechanical pressure acting on the foot during ambulation in the presence of lost protective foot sensation from peripheral neuropathy (5, 6).
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