Diabetic Foot Ulcers

em>By Dr. Mark Hinkes, DPM On June 27, 1991, the International Diabetes Federation (IDF) and World Health Organization (WHO) proclaimed the first World Diabetes Day. Today, World Diabetes Day is celebrated worldwide as an acknowledgement of the condition, symptoms, complications, treatment and resolve to find a cure for the disease. Participants in the celebration include 230 member associations of the International Diabetes Federation in more than 160 countries and territories. All Member States of the United Nations as well as other associations and organizations, companies, health care professionals and people living with diabetes and their families also observe World Diabetes Day. World Diabetes day will be celebrated on Friday, November 14th this year.

Wounds of the lower extremity, such as chronic venous leg ulcers and diabetic foot ulcers, often have a severe impact on patients' quality of life. Symptoms may range from mild to debilitating, depending on the location of the injury and its severity. These types of wounds also affect a tremendous number of people because lower extremity wounds are estimated to occur in up to 13% of the United States population. The estimated annual cost of treating lower extremity wounds is at least $20 billion in the United States.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS Diabetic foot ulcers are one of the most dreaded complications of diabetes, and represent a significant cause of morbidity and mortality. It is estimated that a lower limb is sacrificed every 30 seconds somewhere in the world due to diabetes, and that diabetes is the reason for almost 50% of non-traumatic amputations of the lower leg throughout the world. Considering these facts, proper management of diabetic foot ulcers is of paramount importance.

Holly Hovan MSN, RN-BC, APRN, CWOCN-AP Diabetes is extremely prevalent in the United States. The Centers for Disease Control and Prevention (CDC) report that over 10% of the US population has this chronic disease, and 26.8% of older adults (65 and over) are impacted by diabetes, both diagnosed and undiagnosed.

Chronic and complex wounds of the lower extremity frequently recur. It is difficult to determine the precise recurrence rate across patients with different lower extremity wound types, including diabetic foot ulcers, arterial ulcers, pressure injuries, and venous ulcers. However, we know that recurrence rates are high; nearly 40% of patients with an ulcer will develop a recurrence within one year of healing. This percentage is 60% at three years after healing and 65% at the five-year mark.

Lower extremity wounds such as diabetic foot ulcers (DFUs), venous ulcers, and arterial ulcers have been linked to poor patient outcomes, such as patient mortality and recurrence of the wound. Although precise recurrence rates can be difficult to determine and can vary across different patient populations, we do know that the recurrence rates of lower extremity wounds are quite high.

Temple University School of Podiatric Medicine Journal Review Club Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.