PubMed · 2003 · 551 citations · 0 references
Health ProfessionsOrthopaedic SurgerySurgeryDiabetic Foot CareDiabetologyWound HealingDiabetic Foot DiseaseDiabetic Foot Ulcer CareDiabetic Foot UlcerationDiabetic Neuropathic FootFoot InfectionsMultidisciplinary Foot CareDiabetic Foot DisordersDiabetic Foot Infection ManagementDiabetic Wound PathophysiologyInfected Diabetic Foot ManagementInfected Foot UlcersInfection In Foot UlcersLower-limb AmputationWound Care In Diabetes
Diabetic foot complications arise from peripheral neuropathy and are worsened by peripheral arterial disease, which elevates amputation risk. The study aims to establish a multidisciplinary treatment strategy for diabetic foot ulcers, emphasizing off‑loading, ulcer debridement, glycemic control, and antibiotics. Treatment involves annual monofilament screening, and when osteomyelitis or arterial disease is present, limited bone resection and revascularization are performed respectively.
Diabetic patients are concerned with foot complications when a peripheral neuropathy is present. Screening of predisposed patients may be annually assessed using monofilament testing. Peripheral arterial disease, when associated, increases amputation risk. Ideal treatment requires a multidisciplinary approach with a first-line medical treatment including an optimal off-loading of the diabetic ulcer, ulcer dertersion, glycemic control, and if necessary antibiotic therapy. In case of associated osteomyelitis, a limited surgical resection of the infected bone may be performed. In case of associated arterial disease, a revascularization procedure precede bone resection.