Diabetic Foot Ulcers

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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.

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Holly Hovan's picture

Holly Hovan MSN, APRN, RN-BC, CWOCN-AP

Identifying wound etiology before initiating topical treatment is important. Additionally, correctly documenting wound etiology is significant in health care settings for many reasons. Accurate documentation and appropriate topical treatment are two critical components of a strong wound treatment plan and program. Bedside staff members should be comfortable with describing wounds, tissue types, and differentiating wound etiologies. Training should be provided by the certified wound care clinician, along with follow-up (chart reviews and documentation checks, one-on-one education as needed, and routine competency or education days). Additionally, the wound care clinician should be able to develop an appropriate treatment plan based on wound etiology, by involving additional disciplines as needed to best treat the whole patient.

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By Temple University School of Podiatric Medicine Journal Review Club

Chronic diabetic foot ulcers affect approximately 13% of the United States population. Chronic diabetic foot ulcers, or DFU, are defined by the authors as, “nonhealing ulcers of the foot lasting more than 3 months’ duration in patients with diabetes”. It is critical to treat DFUs effectively and timely, as ulcers may progress to the point of requiring an amputation. Patients suffering from a DFU may have an amputation rate of 21.5% to 28.4%.

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By the WoundSource Editors

Collateral circulation: A collateral blood vessel circuit that may be adapted or remodeled to minimize the use of occluded arteries. Collateralization may offset some of the physiological signs of peripheral artery disease, such as maintaining a normal capillary refill.

Critical limb ischemia: A severe form of peripheral arterial disease in which a severe blockage of the arteries of the lower extremities reduces blood flow. It is a chronic condition that is often characterized by wounds of the lower extremity.

Dependent rubor: A light red to dusky-red coloration that is visible when the leg is in a dependent position (such as hanging off the edge of a table) but not when it is elevated above the heart. The presence of dependent rubor is often an indicator of underlying peripheral arterial disease. When the leg is raised above the level of the heart, its color will normalize.

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By the WoundSource Editors

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.

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By the WoundSource Editors

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.

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By Industry News

Miami, FL – June 1, 2020 – Amniox Medical, Inc. (Amniox), a TissueTech, Inc. company, announced today the results from the one-year follow-up study to their Phase 2 open label, multicenter pilot study of Cryopreserved Umbilical Cord allograft TTAX01. The objectives of the study were to examine the safety and efficacy of TTAX01, plus standard of care, in achieving complete wound closure of complex non-healing Diabetic Foot Ulcers (DFUs) with evidence of exposed bone, tendon, muscle and/or joint capsule and clinical suspicion of osteomyelitis. Results of this one-year study are published in the peer-reviewed journal Wound Repair and Regeneration.

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Frequently Asked Questions

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.

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 Evidence-Based Product for Diabetic Foot Ulcer Management

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.

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Diabetic Foot Ulcer Care and Patient Support

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.

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