Management of Diabetic Foot
Key Points
Key Points
Every year, >1 million people with diabetes suffer limb loss as a result of diabetes.
Approximately 80% of diabetes-related lower extremity amputations are preceded by a foot ulcer.
This progression from foot ulcer to amputation lends to several possible steps where intervention based on evidence-based guidelines may prevent major amputation.
Prevention
...evention...
...on of Diabetic Foot Ulceration...
We recommend that patients with diabetes...
...ommend that foot examination include testing...
...ucation of the patients and their...
...rapeutic Footwear:...
...suggest against the routine use of special...
...d using custom therapeutic footwear in hig...
...quate glycemic control (hemoglobin A1c...
...end against prophylactic arterial revascularizatio...
Assessment
...essment
...e 1. Suggested Frequency for Follow-Up Evaluat...
...Diabetic Foot Osteomyelitis (DFO)
...n patients with a diabetic foot infec...
...ients presenting with a new DFI, we suggest th...
...r those patients who require additional (i...
...ts with suspected DFO for whom MRI is contraindica...
...ients at high risk for DFO, we recommend that...
...one is débrided to treat osteomyelitis, we recom...
...or patients not undergoing bone dé...
...pheral Arterial Disease (PAD) and the...
...at patients with diabetes have ankle-brachial...
...that patients with diabetes who have a pri...
...recommend that patients with DFU have p...
...s with DFU who have PAD, we recommend...
...mplementation RemarksPrediction of patient...
...gure 1. Hemodynamics and Probability...
Treatment
...reatment...
...f-Loading D...
In patients with plantar DFU, we recommend off...
...th DFU requiring frequent dressing change...
...suggest against using postoperative shoes or st...
...n patients with nonplantar wounds, we recommend u...
...patients with healed DFU (includi...
...und Care For DFUs...
...frequent evaluation at 1- to 4-week interv...
...commend evaluation for infection o...
...est that treatment of DFIs should follow the mo...
...mend use of dressing products that maintain a...
...ecommend sharp débridement of all devitalized tis...
...idering lack of evidence for superi...
...fail to demonstrate improvement (>50% wound...
...suggest the use of negative pressur...
...suggest consideration of the use of PDGF (be...
...nsideration of living cellular the...
We suggest consideration of the use of ext...
...ith DFU who have adequate perfusion...
...2. Algorithm for Prevention and Care of...
.... Lower Extremity Threatened Limb (SV...
...deline Recommendation Highli...