Current concepts for the evaluation and management of diabetic foot ulcers

Andreas F Mavrogenis; Panayiotis D Megaloikonomos; Thekla Antoniadou; Vasilios G Igoumenou; Georgios N Panagopoulos; Leonidas Dimopoulos; Konstantinos G Moulakakis; George S Sfyroeras; Andreas Lazaris

doi:10.1302/2058-5241.3.180010

Current concepts for the evaluation and management of diabetic foot ulcers

EFORT Open Rev. 2018 Sep 27;3(9):513-525. doi: 10.1302/2058-5241.3.180010. eCollection 2018 Sep.

Authors

Andreas F Mavrogenis¹, Panayiotis D Megaloikonomos¹, Thekla Antoniadou¹, Vasilios G Igoumenou¹, Georgios N Panagopoulos¹, Leonidas Dimopoulos¹, Konstantinos G Moulakakis², George S Sfyroeras², Andreas Lazaris²

Affiliations

¹ First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece.
² Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece.

Abstract

The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates.More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation.Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia. Cite this article: EFORT Open Rev 2018;3:513-525. DOI: 10.1302/2058-5241.3.180010.

Keywords: diabetic foot ulcers; infection; osteomyelitis; revascularization; wound dressings.