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This can range from a simple break in the epithelial integrity of the skin or it can be deeper, extending into subcutaneous tissue with damage to other structures such as tendons, muscles, vessels, nerves, parenchymal organs, and bones [12, 13]

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42 Gastrointestinal autonomic neuropathy Gastrointestinal autonomic neuropathy affects the enteric nervous system, leading to dysregulation of gastrointestinal motility and function