Diabetic foot ulceration is a major complication of diabetes and afflicts as many as 15 to 25% of type 1 and 2 diabetes patients during their lifetime. If untreated, diabetic foot ulcers may become infected and require total or partial amputation of the affected limb. Early identification of tissue at risk of ulcerating could enable proper preventive care, thereby reducing the incidence of foot...

Dr Paul Brand was the first to widely use Total Contact Casting (TCC) in the mid 1960’s to offload the insensate foot in Hansen’s disease (Sinacore et al, 1987). It has since been identified as a ‘Gold Standard’ for offloading diabetic foot ulceration within the diabetic foot-care community (Boulton, 2004).

The majority of foot ulcers appear to result from minor trauma in the presence of sensory neuropathy. This best describes the critical triad most commonly seen in patients with diabetic foot ulcers: peripheral sensory neuropathy, deformity, and trauma. All three of these risk factors are present in 65% of diabetic foot ulcers. Calluses, edema, and peripheral vascular disease have also been iden...

BACKGROUND Diabetic foot ulceration is common, affecting 1.0%-4.1% of diabetic persons per year and up to 25% in a lifetime. Diabetic foot ulcers are multifactorial in origin, and many are slow to heal and/or are complicated by infection, frequently leading to amputation. Hyperbaric oxygen therapy has been suggested for numerous indications, and it is recognized by funding agencies for a smalle...

Neil Baker is a Principal Diabetes Specialist and Research Podiatrist, Ipswich Hospital NHS Trust, Ipswich. Colin Kenny is a GP, Dromore, County Down. Costs associated with diabetic foot complications place an enormous burden upon the health economy, particularly if amputations occur, with associated prolonged inpatient care. There is a very considerable human cost with amputations, as well as ...

INTRODUCTION It is very suggestive that diabetic foot is characterized by a pronounced inflammatory reaction and the pathogenic significance of this inflammation has received little attention. On this basis the aim of our study was to evaluate plasma levels of adiponectin, resistin and IL-6 in subjects with diabetic foot in comparison with subjects without foot complications. MATERIALS AND ME...

Diabetic foot ulceration is both preventable and treatable. The management of diabetic foot disease is best achieved through implementation of local protocols involving the primary care team, community care and the multidisciplinary diabetic team. It is important that the feet the assessed as part of the overall assessment of a diabetic patient at any clinical presentation. The initial manageme...

OBJECTIVE To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers. QUALITY OF EVIDENCE A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled...

Diabetic foot ulceration is a common, yet in many cases an eminently preventable, complication that affects 1 in 20 patients with diabetes. Risk factors for ulceration include insensitivity (secondary to somatic neuropathy), high foot pressures, callus formation (a consequence of sympathetic neuropathy and high foot pressures), deformities (such as claw feet, prominent metatarsal heads, etc.), ...