Differences between venous and arterial foot ulcers.

you go through the differences of the venous and the arterial foot ulcers? Sure, so generally when we're looking at diabetic patients what we see is people who have a combination of three problems really. So the first problem is neuropathy and so what that means is that the nerves get damaged directly through the high sugar levels and those can be the sensory nerves so that people don't feel pain when they injure their foot and so they present late to the doctor. They also develop foot deformity from problems with the nerves that supply the muscles in their foot so instead of a normal foot with an arch they can develop a claw foot or a flat foot. And then they also have autonomic neuropathy. So what this means is they don't sweat, so they get cracks. And so you add all that up and you get a deformed foot with abnormal pressure points. And this can get repetitive trauma without feeling anything. Great example of that, Charcot arthropathy, where you get fractures and bone destruction in the middle of the foot and patient feels absolutely nothing. So adding to that problems with accelerated arterial disease, so that's the sort of next stage, so those little cracks and wounds that don't heal, they really progress and can develop into large wounds with gangrene And those are the mainstays of the mechanisms really in diabetic foot disease.