Terms to Know: Diabetic Foot Ulcers

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by the WoundSource Editors

Cellular and/or tissue-based products: Formally referred to as skin substitutes, these are engineered products, both cellular and acellular, intended to facilitate biological repair or regeneration of wound tissue by providing signaling, structural, or cellular elements.

Debridement: Intentional removal of non-viable tissue and debris from the wound through one or more modalities, some of which are selective for non-viable tissue and some which are non-selective (sharp [conservative or excisional/surgical], mechanical, autolytic, enzymatic/chemical, and biological.

Diabetic peripheral neuropathy: Many patients with diabetes have this condition affecting the function of the sensory, motor, and autonomic nervous systems and resulting in loss of protective sensation, biomechanical deformities of the foot, and altered sweat gland function, respectively.

Ischemia: Insufficient vascular supply possibly resulting in tissue damage if no intervention occurs; can be caused by either acute obstruction (critical limb ischemia) or constriction (possibly chronic vascular complications of disease states such as diabetes mellitus).

Mixed-etiology ulcer: This term refers to foot ulcerations in patients with diabetes that are multifactorial and are often confounded by concomitant issues such as ischemia.

Offloading: The mechanical process of distributing weight and dynamic forces evenly; this can be accomplished with external application of layers of padding and placement of a rigid device over the lower extremity for healing of diabetic foot ulcers.

Osteomyelitis: Presence of clinical infection penetrating cancellous and surrounding cortical bone; in diabetic foot ulcers, osteomyelitis is often treated by resecting the affected bone and adjacent tissue or with the administration of a prolonged course of oral or intravenous antibiotics.

Pre-ulcerative lesion: More commonly known as a callus, or a localized area of hypertrophied stratum corneum, typically found on the plantar, medial, and lateral surfaces of the foot, and indicating an area of repetitive external pressure or trauma; in patients with diabetes, calluses are exacerbated by peripheral neuropathy.

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