Management of diabetic foot: Brief synopsis for busy orthopedist

Abstract

According to available medical reports, over 10% of diabetic patients will develop foot ulcers during their lifetimes. This condition still remains great challenges to many clinicians. Various mechanisms may explain treatment-resistant entity. Treatment varies widely, relying on the severity of the ulceration as well as the presence of infection or ischemia. However, the most important things to keep in mind should consist of the following: 1) appropriate debridement; 2) off-loading of pressure; 3) effective control of infection; 4) local wound care strategy; 5) timely reconstructive surgery. The ideal flap for diabetic foot reconstruction should provide a well-vascularized tissue to control infection, adequate contour for footwear, durability, and solid anchorage to resist shearing forces. A thorough assessment of patient's general condition and voluntary motivation of the patient should be warranted to prevent any sort of postoperative recurrence.

Metatarsal Head Resection Versus a Removable Mechanical Device for Offloading of the Neuropathic Diabetic Plantar Forefoot Ulcer

“…Diversity of management methods for neuropathic DFU treatment exists, which means that nothing is satisfactory on its own. 15 The following methods usually are adjuvant to healing, such as hyperbaric oxygen, 16 wound matrix, 17 platelet-rich plasma application or injection, 18 vacuum-assisted closure, 19 growth factors, and stem cell therapy. 20 However, unequal distribution of the mechanical pressure over the foot plantar areas can hinder the healing process or cause ulcer recurrence.…”

Neurotensin-loaded PLGA/CNC composite nanofiber membranes accelerate diabetic wound healing

“…Diabetic foot ulcers (DFUs) are a threat to human health and can lead to amputation and even death [1,2]. More than 10% of diabetic patients develop DFUs at some point in their lives [3]. Treatments for DFUs include various drugs [4], several types of wound dressing or skin substitutes such as Integra V R dermal regeneration template [5] and dermal replacement [6][7][8].…”

Daptomycin in the Treatment of Diabetic Foot Infections without Osteomyelitis; A Multicenter Study

“…Özellikle diyabetik ayak infeksiyonları diyabetik hastalarda önemli mortalite ve morbiditeye neden olabilir. Diyabet hastalarının yaklaşık %10-15'inde hayatlarının bir döneminde diyabetik ayak infeksiyonu geliştiği bildirilmiştir [1,2] . Bu hastalar arasında her 30 saniyede bir diyabete bağlı alt ekstremite kaybı gerçekleşmektedir [3][4][5] .…”