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
...Prevention...
...Prevention...
...recommend that patients with diabetes und...
...mend that foot examination include testing f...
...nd education of the patients and their families ab...
...Thera...
...st the routine use of specialized therapeutic foot...
We recommend using custom therapeutic footw...
...est adequate glycemic control (hemo...
...ainst prophylactic arterial revascular...
Assessment
...Assessment...
...1. Suggested Frequency for Follow-Up Eval...
...Diagnosis...
...ients with a diabetic foot infection (DFI) w...
...presenting with a new DFI, we suggest that ser...
...hose patients who require additional (ie...
...suspected DFO for whom MRI is contr...
...at high risk for DFO, we recommend that the di...
...n bone is débrided to treat osteomyeli...
...not undergoing bone débridement, we sugges...
...Periphera...
...st that patients with diabetes have a...
...t that patients with diabetes who have a prior hi...
...end that patients with DFU have pedal perfusion as...
...with DFU who have PAD, we recommend re...
...ical and Implementation RemarksPrediction...
...emodynamics and Probability of Healing of a D...
Treatment
...Off-Loading...
In patients with plantar DFU, we r...
...patients with DFU requiring freque...
...uggest against using postoperative shoes or stand...
...ith nonplantar wounds, we recommend...
...high-risk patients with healed DFU (including...
...Wound...
...end frequent evaluation at 1- to 4...
...mend evaluation for infection on initi...
...that treatment of DFIs should follow the mos...
...mmend use of dressing products that m...
...mend sharp débridement of all devitaliz...
...lack of evidence for superiority of any g...
...DFUs that fail to demonstrate impr...
...use of negative pressure wound therapy for ch...
...nsideration of the use of PDGF (becapl...
...ideration of living cellular therapy...
...st consideration of the use of extracellu...
...with DFU who have adequate perfusion that fai...
...ithm for Prevention and Care of Diab...
...able 2. Lower Extremity Threatened...
...eline Recommendation Highl...