Diabetic Foot Ulcers

By the WoundSource Editors

Chronic wounds pose an ongoing challenge for clinicians, and there needs to be a clearer understanding of the pathophysiology of wound chronicity and treatment modalities available.

By Windy Cole, DPM

In my recent WoundSource webinar, I discussed the topic of diabetic foot ulcers (DFUs) and using advanced therapies to encourage their healing. The webinar is still available for viewing on WoundSource.com. Chronic lower extremity wounds present significant challenges with regard to effective wound management. Ischemia, microcirculatory dysfunction and peripheral vascular disease cause limitations in blood flow that can delay the healing process.

By the WoundSource Editors

When determining the course of action for treating a given wound, it is important that wound care clinicians evaluate how advanced wound care therapies have been deemed evidence based and how the specific product technology works. Evidence-based advanced wound care products are required to be safe and effective based on epidemiology, etiology, and pathophysiology. However, safety and efficiency are not a 100% guarantee of effectiveness in clinical practice.

By the WoundSource Editors

Diabetic foot ulcer (DFU) complications are challenging and costly. Evidence-based practice and advanced wound care technologies have the potential to maximize good outcomes and prevent ulcer recurrence, but ensuring that patients receive education on diabetes management and DFU prevention is also a vital step. Over time, people with unmanaged diabetes have increased chances of complications such as neuropathy, peripheral vascular disease (PVD), chronic DFUs, infections, osteomyelitis, amputation, and even death.

By the WoundSource Editors

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

By the WoundSource Editors

Diabetic foot ulcers (DFUs) continue to be a major problem, causing patient suffering, burden, infections, and high mortality. The cost of DFU treatment was estimated at $1.3 trillion globally in 2015. Despite evolving advanced wound care technologies through the years, DFUs continue to be among the most challenging chronic wound types.

by the WoundSource Editors

ADA Diabetic Foot Risk Classification Table: A tool to help identify patient risk factors and urgency that includes priorities, indications, timelines, and suggested follow-ups.

By Temple University School of Podiatric Medicine Journal Review Club

Article Title: Mesenchymal Stem Cells Improve Healing of Diabetic Foot Ulcer
Authors: Cao Y, Gang X, Wang G
Journal: J Diabetes Res. 2017;2017:9328347.
Reviewed by: Sai Vemula, class of 2020, Temple University School of Podiatric Medicine

Temple University School of Podiatric Medicine Journal Review Club

Delayed healing in diabetic foot ulcers (DFUs) is the result of the polymicrobial structures of DFUs and the buildup of biofilms. Wound debridement is an essential part of wound bed preparation (WBP) that helps to remove bacteria and allow the body to continue the healing process. Although sharp debridement is the most common technique used for DFUs, it has many limitations, including contraindications in patients with poor vascular status, the need for an operating room, and the requirement for specific surgeon skills. There is also the potential for extensive damage to the wound bed with exposed bone because of obstruction of the view from biofilm formation. The use of an ultrasound-assisted wound (UAW) debridement device aims to disrupt the formation of biofilms and stimulate wound granulation, thus allowing for the wound to have a healthy environment in which to heal. This study evaluated the clinical and microbiological impact of using UAW debridement devices in individuals with neuroischemic DFUs.

By Hy-Tape International

According to a published study, the global prevalence of diabetic foot ulcers (DFUs) is 6.3%, with male patients and older adults being the most likely to be affected.¹ This prevalence, coupled with the potential for complications and the severe effect on quality of life the condition can have, makes DFUs one of today's most serious health care issues. To reduce the effects of DFUs and improve outcomes for patients, it is critical that health care professionals rapidly identify DFUs and implement best practice dressing and management strategies.