Surgery Book

Dermatology

  • Diabetic Foot Ulcer

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Diabetic Foot UlcerAka: Neuropathic Foot Ulcer

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  1. Pathophysiology
    1. Sensory protection is lost
      1. Results in chronic trauma
      2. Tissue breaks down in traumatized area
      3. Charcot changes result in additional pressure points
    2. Complicating factors
      1. Peripheral Vascular Disease
      2. Osteomyelitis
  2. Evaluation
    1. Assess for Osteomyelitis
    2. Assess for foreign body
    3. Assess for circulatory problem
  3. Management
    1. Offloading is key
      1. Ongoing trauma persists until non-weight bearing
      2. Options
        1. Use Crutches, walker or wheelchair
        2. Darko Shoe (half shoe not offloads distal foot)
        3. CAM Walker or cast
    2. Dressings (moist healing is critical)
      1. Wet-to-Moist Dressing (cost effective, first line)
      2. Silver products (e.g. Acticoat)
      3. Debridement salves (e.g. accuzyme)
      4. Other more complex and expensive options
        1. Promogran
        2. Becaplermin (Regranex)
        3. Bioengineered skin graft
    3. Determine if antibiotics are appropriate
    4. Remove Callus (causes pressure areas)

Foot Ulcer, Diabetic (C1456868)

ConceptsDisease or Syndrome (T047)
MSHD017719
EnglishDiabetic foot ulcer
Spanishulcera pedica diabetica
Parent ConceptsFoot Ulcer (C0085119), Diabetic complications (C0271672)
SourcesMSH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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