Diabetic Foot

WoundSource Practice Accelerator's picture
Wound Assessment

by the WoundSource Editors

Thorough, systematic assessment of a patient with a diabetic foot ulcer (DFU) is essential to developing a comprehensive plan of care. To implement the treatment plan successfully, clinicians and patients must work together to address each factor contributing to ulcer development and perpetuation.

Temple University School of Podiatric Medicine's picture
Temple University

Diabetic foot ulcers do not always respond well to conventional wound healing methods for a multitude of reasons. Fibroblasts in people with diabetes have decreased migration and proliferation potential as a result of increased metalloproteinase levels in the wound bed of diabetic foot ulcers. These patients are also prone to bacterial infection within the wound because of the immunocompromised status of a patient with diabetes. Negative-pressure wound therapy (NPWT) can mediate these issues. The precise mechanism of action of NPWT is not clearly defined, but some possibilities have been conceptually determined. NPWT stimulates cell activity and migration, decreases bioburden in the wound by removing fluid, and reduces edema. However, the authors theorized that the increased pressure induced by NPWT on the skin could cause decreased tissue oxygenation in the wound bed.

Blog Category: 
James McGuire's picture
View of Pressure Points on a Foot

by James McGuire, DPM, PT, CPed, FAPWH

According to the American Diabetes Association, there are 29.1 million Americans with diabetes, 8.1 million of whom are walking around undiagnosed.1 This number is dwarfed by the 86 million Americans who have been classified as having prediabetes and who are at risk for developing diabetes in the near future. Each year, 1.7 million Americans age 20 years or older — 4,660 per day, or one every 19 seconds — are added to the rolls and begin a slow but steady acquisition of the devastating complications of the disease.

Blog Category: 
Susan Cleveland's picture
Long-Term Care Patient

by Susan M. Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

As a Director of Nursing (DON) in a long-term care facility, do you know where the awareness level of diabetes and its complications is for your staff? Do they realize diabetes doesn’t stop? It is 24/7, 365 days a year. Knowing this reality of diabetes and understanding the disease process may assist with preventing serious health problems such as heart disease, stroke, blindness, kidney disease, and nerve damage that can lead to amputation.

Blog Category: 
Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

A major concern in managing patients with diabetes is their susceptibility to acquiring ulcers in their feet. If these patients are not careful, these ulcers may become infected and eventually lead to additional sequelae, ending in lower extremity amputation. The focus of this study was to determine the major factors of lower extremity amputation in the diabetic foot, in hopes that clinicians may be able to reduce the rate of amputations more effectively.

Blog Category: 
WoundSource Editors's picture
Diabetes and wound healing

For individuals with diabetes, all wounds are a serious health concern and require careful attention. Because of diabetic peripheral neuropathy, skin cuts and blisters often go unnoticed until they become more complicated to heal. In addition, internal wounds such as ingrown toenails, skin ulcers, or calluses can cause breakdown of tissue and an increased risk of infection. Even small cuts and insect bites can cause wound healing difficulties in patients with diabetes. Here are common factors of diabetes that impact wound healing:

Blog Category: 
WoundSource Editors's picture
diabetic foot ulcer treatment

Estimates are that by 2030 there will be 550 million individuals with diabetes in the world. Because almost a quarter of all people with diabetes will develop a foot ulcer at some point, health care workers need to know the best practices for diabetic foot ulcer prevention and treatment.

Blog Category: 
Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

One fourth of the approximately 22.3 million patients with diabetes in the United States are expected to develop a diabetic foot ulcer (DFU) at some point during their lives, and it is estimated to affect 1-8% of diabetics annually. DFUs have shown to be challenging to treat, and often result in extended hospital stays, increased risk of infection, and subsequent amputation in certain patients. A major concern regarding amputees is a 5-year mortality rate that rivals that of patients with colon cancer. In addition, DFUs contribute heavily to the financial load of payers, with an estimated annual medical cost of up to $13 billion.

Blog Category: 
Martin Vera's picture
diabetic foot ulcer

By Martin D. Vera LVN, CWS

In this last of our three-part series on lower extremity wounds, we will focus our attention to diabetic foot/neuropathic ulcers. Research indicates that the United States national average for diabetes mellitus (DM) accounts for a little over 8% of the nation, or roughly over 18 million Americans afflicted with this disease—what the industry refers to "the silent killer" for the amount of damage it causes. DM has the capacity to affect vision and circulation, as well as increase the incidence of stroke and renal disease, just to name a few associated problems. Over 20% of individuals with diabetes will develop ulcerations, with a recurrence rate of over 50% for diabetic foot ulcers (DFUs) alone. Overall, lower extremity wounds have recurrence rate of 40-90%. We have our work cut out for us. So, let's put our deuces up, recognize early intervention, and try our best to manage and prevent complications associated with DM.

Blog Category: 
Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Chronic wounds and ulcerations induced by complications associated with diabetes mellitus have proven to be a burden to the patients themselves, as well as the healthcare system as a whole. This burden has required physicians to not only find interventions that work better, but are also more cost effective. In the population with diabetes, 1 out of 4 will have an ulceration of the lower extremity at some point in their life. It’s also important to state that these foot ulcers can lead to some form of amputation in 20% of these patients. Standard wound care typically involves moist dressings, debridement, wound offloading, infection control, and in some cases, advanced therapies. The authors of this study looked into two of these advanced therapies, bioengineered skin substitutes (BSS) and dehydrated human amnion/chorion membranes (dHACM.) The primary objective of the study was to see which worked best, as compared to standard wound care (SWC), while the secondary objective was to see which had the lowest costs.