- Management of diabetic foot ulcers: a narrative review
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Jahyung Kim, Otgonsaikhan Nomkhondorj, Chi Young An, Ye Chan Choi, Jaeho Cho
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Received June 26, 2023 Accepted August 10, 2023 Published online September 22, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00682
[Epub ahead of print]
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 Abstract
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- Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.
- Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review
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Chi Young An, Seung Lim Baek, Dong-Il Chun
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Received June 30, 2023 Accepted August 15, 2023 Published online September 19, 2023
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DOI: https://doi.org/10.12701/jyms.2023.00717
[Epub ahead of print]
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Abstract
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- Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient’s general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.
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E-Submission
Yeungnam University College of Medicine
