Terms to Know: Diabetic Foot Ulcers

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by the WoundSource Editors

Callus: Localized area where the stratum corneum is thickened, typically found bordering ulcerations on the plantar, medial, and lateral surfaces of the foot; in the setting of diabetic foot ulcer, this indicates an area of repetitive external pressure or trauma.

Cellular and/or tissue-based product: Engineered products created to promote biological repair or regeneration of wound tissue by providing signaling, structural, or cellular elements with or without systems that contain living tissue or cells.

Charcot arthropathy: A pathologic biomechanical deformity of the foot in patients with diabetes mellitus involving disruption or disintegration of the joints of the foot and ankle, typically accompanied by erythema and edema.

Debridement: The procedural act of removing nonviable tissue, along with any debris from the wound. There are multiple debridement modalities, some of which are selective for nonviable tissue and some of which are nonselective (viable tissue is removed as well, e.g. mechanical debridement with gauze sponges): sharp (conservative or excisional/surgical), mechanical, autolytic, enzymatic/chemical, and biologic.

Growth factor: Protein-derived substances that act as chemical messengers, signaling cells to initiate proliferative and migratory activity. They are used to stimulate senescent cells or cells with little to no biologic activity in chronic wounds such as diabetic foot ulcer.

Hyperbaric oxygen therapy (HBOT): The systemic administration of oxygen under pressure at a concentration exceeding 20%, used to increase oxygen concentration and perfusion as an advanced modality in the treatment plan of diabetic foot ulcer meeting specific classification criteria.

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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).

Neuropathy: A condition common in patients with long-standing diabetes mellitus that affects the function of the sensory, motor, and autonomic nervous systems; it can result in loss of protective sensation, biomechanical deformities of the foot, and altered sweat gland function.

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

Osteomyelitis: Presence of clinical infection penetrating bone marrow and surrounding bone, in diabetic foot ulcer, often treated by removing the affected bone and adjacent tissue or by administration of a prolonged course of antibiotics.

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