All ethnic groups have a 25% lifetime prevalence of diabetic foot .
doi: 10.1002/dmrr.464.Monteiro-Soares M, Martins-Mendes D, Vaz-Carneiro A, Sampaio S, Dinis-Ribeiro M.Diabetes Metab Res Rev. Diabetic foot infections. del Aguila M, A total of 850 cases of septic diabetic foot infections were reviewed in 355 patients. Boyko EJ, Diabetic foot ulcers: prevention, diagnosis and classification. Harkless LB. Ulbrecht JS, Consensus Development Conference on Diabetic Foot Wound Care: 7–8 April 1999, Boston, Massachusetts. Foot Wound Diabetic Foot Osteomyelitis University of Texas Diabetic Wound Classification. Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief. 2020 May;18(3):208-216. doi: 10.2450/2020.0305-19.
Pecoraro RE, Boyko EJ, Hogge J,
Saving the diabetic foot with special reference to the patient with chronic renal failure. A prospective study of risk factors for diabetic foot ulcer: the Seattle Diabetic Foot Study. The basic interest of having a clinical classification for the different stages of Diabetic Foot is used to articulate the appropriate therapeutic protocols to establish their predictive value when healing an ulcer. The absence of pedal pulses in the presence of a palpable popliteal pulse is a classic finding in diabetic arterial disease because of the selective involvement of the tibial arteries below the knee.Classification of ulcerations can facilitate a logical approach to treatment and aid in the prediction of outcome.Superficial diabetic ulcer (partial or full thickness)Ulcer extension to ligament, tendon, joint capsule, or deep fascia without abscess or osteomyelitisDeep ulcer with abscess, osteomyelitis, or joint sepsisExtensive gangrenous involvement of the entire footSuperficial diabetic ulcer (partial or full thickness)Ulcer extension to ligament, tendon, joint capsule, or deep fascia without abscess or osteomyelitisDeep ulcer with abscess, osteomyelitis, or joint sepsisExtensive gangrenous involvement of the entire footThe University of Texas diabetic wound classification system assesses the depth of ulcer penetration, the presence of wound infection, and the presence of clinical signs of lower-extremity ischemia.The primary goal in the treatment of diabetic foot ulcers is to obtain wound closure.
American Diabetes Association. Veves A, Only patients with Wagner classification grades 1 to 4 were enrolled in the study. The aim of therapy should be early intervention to allow prompt healing of the lesion and prevent recurrence once it is healed. The Wagner classification (Meggitt/Wagner), evaluates 3 parameters: the ulcer’s depth, the degrees of infection and necrosis, this system developed by Wagner to classify diabetic foot ulcers has been widely accepted.A potent vasodilator that improves circulation and helps decrease foot ulcers granulation time in patients with diabetes, evolution time and treatment costs, and the psychological impact and risk of amputation, after a 12-weeks follow-up.
2011 Jan;54(1):58-64. doi: 10.1007/s00125-010-1893-7.
Infect Dis Clin North Am 2001;15:953–81Persons with serious beta-lactam allergy may be given alternative agentsAdapted with permission from Deery HG 2d, Sangeorzan JA. Basis for prevention. The Wagner and University of Texas systems are the ones most frequently used for classification of foot ulcers, and the stage is indicative of prognosis.
To ensure high quality care, practitioners should base their practice on sound clinical evidence. Age, sex, other chronic diseases, site, etiology, Wagner grade, … The diabetic foot: a global view.
Saltzman CL. Involves ligament, tendon, joint capsule or fascia DFUs are … Davignon DR, Armstrong DG, Karlock LG.
Karchmer AW. Catanzariti AR, Assessment and management of foot disease in patients with diabetes. During the past years, several foot-ulcer classification methods have been proposed, however, none of the proposals have been universally accepted.
This article is one in a series of “Office Procedures” articles coordinated by guest editors Robert M. Yoho, D.P.M., M.S., Dean and Associate Professor, and Vincent J. Mandracchia, D.P.M., M.S., Clinical Professor, College of Podiatric Medicine and Surgery, Des Moines University-Osteopathic Medical Center
A phase III randomized placebo-controlled double-blind study. Multidisciplinary management programs that focus on prevention, education, regular foot examinations, aggressive intervention, and optimal use of therapeutic footwear have demonstrated significant reductions in the incidence of lower-extremity amputations.
Epub 2008 Jan 19.Diabetes Metab Res Rev. Fig 1 illustrates Wagner classification for the diabetic foot. Systemic hyperbaric oxygen therapy: lower-extremity wound healing and the diabetic foot.
Pressure relief using total contact casts, removable cast walkers, or “half shoes” is the mainstay of initial treatment. Nguyen HC, Smith DG. Thorough and systematic evaluation and categorization of foot ulcers help guide appropriate treatment.