Diabetic foot secondary prevention: Difference between revisions
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==Secondary Prevention== | ==Secondary Prevention== | ||
The secondary prevention of diabetic foot ulcer includes the following along with the use of primary preventive | The [[Prevention (medical)|secondary prevention]] of [[diabetic foot]] [[ulcer]] includes the following along with the use of [[Prevention (medical)|primary preventive strategies]]:<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28614678 }} </ref><ref name="pmid11280471">{{cite journal| author=Frykberg RG, Armstrong DG, Giurini J, Edwards A, Kravette M, Kravitz S | display-authors=etal| title=Diabetic foot disorders: a clinical practice guideline. American College of Foot and Ankle Surgeons. | journal=J Foot Ankle Surg | year= 2000 | volume= 39 | issue= 5 Suppl | pages= S1-60 | pmid=11280471 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11280471 }} </ref><ref name="pmid11054880">{{cite journal| author=Cavanagh PR, Ulbrecht JS, Caputo GM| title=New developments in the biomechanics of the diabetic foot. | journal=Diabetes Metab Res Rev | year= 2000 | volume= 16 Suppl 1 | issue= | pages= S6-S10 | pmid=11054880 | doi=10.1002/1520-7560(200009/10)16:1+<::aid-dmrr130>3.0.co;2-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11054880 }} </ref><ref name="pmid11475459">{{cite journal| author=Hartsell HD, Fellner C, Saltzman CL| title=Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief. | journal=Foot Ankle Int | year= 2001 | volume= 22 | issue= 6 | pages= 502-6 | pmid=11475459 | doi=10.1177/107110070102200609 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11475459 }} </ref> | ||
*[[Pressure]] offloading | |||
* | **Elevation of the involved [[foot]] | ||
*Prevention of infection | **For total [[pressure]] offloading [[crutch|crutches]] or wheelchairs could be used | ||
* | **Total contact casting (TCC) is the ideal way of [[pressure]] offloading. Nevertheless to avoid any [[Iatrogenesis|iatrogenic]] [[Complication (medicine)|complication]] it should be monitored weekly by an expert [[physician]]. | ||
**Removable walking braces and half shoes could be used as well. | |||
*Rest | |||
*Appropriate [[foot]]wear (such as [[pressure]]-relieving [[foot]]wear) | |||
*[[Prevention (medical)|Prevention]] of [[infection]] | |||
*Appropriate and complete [[infection]] [[treatment]] | |||
*Debridement | *Debridement | ||
*Early amputation | *Early [[amputation]] | ||
*Reconstruction of the damaged vessels | *Reconstruction of the damaged [[Blood vessel|vessels]] | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
The secondary prevention of diabetic foot ulcer includes pressure offloading, prevention of infection, treatment of infection, debridement and reconstruction of the damaged blood vessels, along with the use of primary preventive strategies.[1]
Secondary Prevention
The secondary prevention of diabetic foot ulcer includes the following along with the use of primary preventive strategies:[1][2][3][4]
- Pressure offloading
- Elevation of the involved foot
- For total pressure offloading crutches or wheelchairs could be used
- Total contact casting (TCC) is the ideal way of pressure offloading. Nevertheless to avoid any iatrogenic complication it should be monitored weekly by an expert physician.
- Removable walking braces and half shoes could be used as well.
- Rest
- Appropriate footwear (such as pressure-relieving footwear)
- Prevention of infection
- Appropriate and complete infection treatment
- Debridement
- Early amputation
- Reconstruction of the damaged vessels
References
- ↑ 1.0 1.1 Armstrong DG, Boulton AJM, Bus SA (2017). "Diabetic Foot Ulcers and Their Recurrence". N Engl J Med. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. PMID 28614678.
- ↑ Frykberg RG, Armstrong DG, Giurini J, Edwards A, Kravette M, Kravitz S; et al. (2000). "Diabetic foot disorders: a clinical practice guideline. American College of Foot and Ankle Surgeons". J Foot Ankle Surg. 39 (5 Suppl): S1–60. PMID 11280471.
- ↑ Cavanagh PR, Ulbrecht JS, Caputo GM (2000). "New developments in the biomechanics of the diabetic foot". Diabetes Metab Res Rev. 16 Suppl 1: S6–S10. doi:10.1002/1520-7560(200009/10)16:1+<::aid-dmrr130>3.0.co;2-z. PMID 11054880.
- ↑ Hartsell HD, Fellner C, Saltzman CL (2001). "Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief". Foot Ankle Int. 22 (6): 502–6. doi:10.1177/107110070102200609. PMID 11475459.