eMedicine Specialties > Vascular Surgery > Medical Topics
Diabetic Ulcers: Multimedia
Updated: Oct 28, 2009
Multimedia
![]() | Media file 1: Diabetic ulcer of the medial aspect of left first toe before and after appropriate wound care. |
![]() | Media file 2: Diabetic ulcer of left fourth toe associated with mild cellulitis. |
![]() | Media file 3: Charcot deformity with mal perforans ulcer of plantar midfoot. |
More on Diabetic Ulcers |
| Overview: Diabetic Ulcers |
| Differential Diagnoses & Workup: Diabetic Ulcers |
| Treatment & Medication: Diabetic Ulcers |
| Follow-up: Diabetic Ulcers |
Multimedia: Diabetic Ulcers |
| References |
| Further Reading |
| « Previous Page |
References
Tomic-Canic M, Brem H. Gene array technology and pathogenesis of chronic wounds. Am J Surg. Jul 2004;188(1A Suppl):67-72. [Medline].
Reiber GE, Lipsky BA, Gibbons GW. The burden of diabetic foot ulcers. Am J Surg. Aug 1998;176(2A Suppl):5S-10S. [Medline].
Ramsey SD, Newton K, Blough D, McCulloch DK, Sandhu N, Reiber GE, et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care. Mar 1999;22(3):382-7. [Medline].
Marshall MC Jr. Diabetes in African Americans. Postgrad Med J. Dec 2005;81(962):734-40. [Medline].
Gentile AT, Berman SS, Reinke KR, Demas CP, Ihnat DH, Hughes JD, et al. A regional pedal ischemia scoring system for decision analysis in patients with heel ulceration. Am J Surg. Aug 1998;176(2):109-14. [Medline].
Mayfield JA, Sugarman JR. The use of the Semmes-Weinstein monofilament and other threshold tests for preventing foot ulceration and amputation in persons with diabetes. J Fam Pract. Nov 2000;49(11 Suppl):S17-29. [Medline].
Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med. Jul 1 2004;351(1):48-55. [Medline].
Arora S, Pomposelli F, LoGerfo FW, Veves A. Cutaneous microcirculation in the neuropathic diabetic foot improves significantly but not completely after successful lower extremity revascularization. J Vasc Surg. Mar 2002;35(3):501-5. [Medline].
Boulton AJ. Pressure and the diabetic foot: clinical science and offloading techniques. Am J Surg. May 2004;187(5A):17S-24S. [Medline].
Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. May 3 2003;361(9368):1545-51. [Medline].
Teodorescu VJ, Chen C, Morrissey N, Faries PL, Marin ML, Hollier LH. Detailed protocol of ischemia and the use of noninvasive vascular laboratory testing in diabetic foot ulcers. Am J Surg. May 2004;187(5A):75S-80S. [Medline].
Dutta P, Bhansali A, Mittal BR, Singh B, Masoodi SR. Instant 99mTc-ciprofloxacin scintigraphy for the diagnosis of osteomyelitis in the diabetic foot. Foot Ankle Int. Sep 2006;27(9):716-22. [Medline].
Edmonds M, Foster A. The use of antibiotics in the diabetic foot. Am J Surg. May 2004;187(5A):25S-28S. [Medline].
O'Meara SM, Cullum NA, Majid M, Sheldon TA. Systematic review of antimicrobial agents used for chronic wounds. Br J Surg. Jan 2001;88(1):4-21. [Medline].
Brem H, Balledux J, Bloom T, Kerstein MD, Hollier L. Healing of diabetic foot ulcers and pressure ulcers with human skin equivalent: a new paradigm in wound healing. Arch Surg. Jun 2000;135(6):627-34. [Medline].
Beckert S, Witte M, Wicke C, Königsrainer A, Coerper S. A new wound-based severity score for diabetic foot ulcers: A prospective analysis of 1,000 patients. Diabetes Care. May 2006;29(5):988-92. [Medline].
Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. Jan 2001;24(1):84-8. [Medline].
Robson MC, Hill DP, Woodske ME, Steed DL. Wound healing trajectories as predictors of effectiveness of therapeutic agents. Arch Surg. Jul 2000;135(7):773-7. [Medline].
Muha J. Local wound care in diabetic foot complications. Aggressive risk management and ulcer treatment to avoid amputation. Postgrad Med. Jul 1999;106(1):97-102. [Medline].
Pinzur MS, Slovenkai MP, Trepman E, Shields NN. Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society. Foot Ankle Int. Jan 2005;26(1):113-9. [Medline].
Edmonds M. Diabetic foot ulcers: practical treatment recommendations. Drugs. 2006;66(7):913-29. [Medline].
Bello YM, Phillips TJ. Recent advances in wound healing. JAMA. Feb 9 2000;283(6):716-8. [Medline].
Frykberg RG, Armstrong DG, Giurini J, Edwards A, Kravette M, Kravitz S, et al. Diabetic foot disorders. A clinical practice guideline. For the American College of Foot and Ankle Surgeons and the American College of Foot and Ankle Orthopedics and Medicine. J Foot Ankle Surg. 2000;Suppl:1-60. [Medline].
Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA. Risk factors for delayed healing of neuropathic diabetic foot ulcers: a pooled analysis. Arch Dermatol. Dec 2000;136(12):1531-5. [Medline].
Beuker BJ, van Deursen RW, Price P, Manning EA, van Baal JG, Harding KG. Plantar pressure in off-loading devices used in diabetic ulcer treatment. Wound Repair Regen. Nov-Dec 2005;13(6):537-42. [Medline].
Hilton JR, Williams DT, Beuker B, Miller DR, Harding KG. Wound dressings in diabetic foot disease. Clin Infect Dis. Aug 1 2004;39 Suppl 2:S100-3. [Medline].
Veves A, Falanga V, Armstrong DG, Sabolinski ML. Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical trial. Diabetes Care. Feb 2001;24(2):290-5. [Medline].
Bennett SP, Griffiths GD, Schor AM, Leese GP, Schor SL. Growth factors in the treatment of diabetic foot ulcers. Br J Surg. Feb 2003;90(2):133-46. [Medline].
Guzman-Gardearzabal E, Leyva-Bohorquez G, Salas-Colín S, Paz-Janeiro JL, Alvarado-Ruiz R, García-Salazar R. Treatment of chronic ulcers in the lower extremities with topical becaplermin gel .01%: a multicenter open-label study. Adv Ther. Jul-Aug 2000;17(4):184-9. [Medline].
Platelet-derived growth factor for diabetic ulcers. Med Lett Drugs Ther. Jul 17 1998;40(1031):73-4. [Medline].
Jirkovská A, Boucek P, Wosková V, Bartos V, Skibová J. Identification of patients at risk for diabetic foot: a comparison of standardized noninvasive testing with routine practice at community diabetes clinics. J Diabetes Complications. Mar-Apr 2001;15(2):63-8. [Medline].
Evans D, Land L. Topical negative pressure for treating chronic wounds: a systematic review. Br J Plast Surg. Apr 2001;54(3):238-42. [Medline].
Strauss MB. Hyperbaric oxygen as an intervention for managing wound hypoxia: its role and usefulness in diabetic foot wounds. Foot Ankle Int. Jan 2005;26(1):15-8. [Medline].
Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Plast Reconstr Surg. Jun 2006;117(7 Suppl):212S-238S. [Medline].
Wieman TJ, Mercke YK, Cerrito PB, Taber SW. Resection of the metatarsal head for diabetic foot ulcers. Am J Surg. Nov 1998;176(5):436-41. [Medline].
Faries PL, Teodorescu VJ, Morrissey NJ, Hollier LH, Marin ML. The role of surgical revascularization in the management of diabetic foot wounds. Am J Surg. May 2004;187(5A):34S-37S. [Medline].
Marston WA, Davies SW, Armstrong B, Farber MA, Mendes RC, Fulton JJ. Natural history of limbs with arterial insufficiency and chronic ulceration treated without revascularization. J Vasc Surg. Jul 2006;44(1):108-114. [Medline].
Ehrenreich M, Ruszczak Z. Update on tissue-engineered biological dressings. Tissue Eng. Sep 2006;12(9):2407-24. [Medline].
Streit M, Braathen LR. Apligraf--a living human skin equivalent for the treatment of chronic wounds. Int J Artif Organs. Dec 2000;23(12):831-3. [Medline].
Demiri E, Foroglou P, Dionyssiou D, Antoniou A, Kakas P, Pavlidis L, et al. Our experience with the lateral supramalleolar island flap for reconstruction of the distal leg and foot: a review of 20 cases. Scand J Plast Reconstr Surg Hand Surg. 2006;40(2):106-10. [Medline].
Brem H, Sheehan P, Rosenberg HJ, Schneider JS, Boulton AJ. Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg. Jun 2006;117(7 Suppl):193S-209S; discussion 210S-211S. [Medline].
[Best Evidence] Hiatt WR, Money SR, Brass EP. Long-term safety of cilostazol in patients with peripheral artery disease: the CASTLE study (Cilostazol: A Study in Long-term Effects). J Vasc Surg. Feb 2008;47(2):330-336. [Medline].
Roeckl-Wiedmann I, Bennett M, Kranke P. Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg. Jan 2005;92(1):24-32. [Medline].
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. Jan 12 2005;293(2):217-28. [Medline].
The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. Sep 30 1993;329(14):977-86. [Medline].
Galkowska H, Olszewski WL, Wojewodzka U, Rosinski G, Karnafel W. Neurogenic factors in the impaired healing of diabetic foot ulcers. J Surg Res. Aug 2006;134(2):252-8. [Medline].
[Guideline] Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. Oct 1 2004;39(7):885-910. [Medline].
Further Reading
Clinical guidelines
Wound, Ostomy, and Continence Nurses Society (WOCN). Guideline for management of wounds in patients with lower-extremity neuropathic disease. Glenview (IL): Wound, Ostomy, and Continence Nurses Society (WOCN); 2004. 57 p. (WOCN clinical practice guideline; no. 3).
National Collaborating Centre for Primary Care. Clinical guidelines for type 2 diabetes. Prevention and management of foot problems. London (UK): National Institute for Clinical Excellence (NICE); 2004 Jun. 104 p.
Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, Lefrock JL, Lew DP, Mader JT, Norden C, Tan JS. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004 Oct 1;39(7):885-910. 47
Registered Nurses Association of Ontario (RNAO). Assessment and management of foot ulcers for people with diabetes. Toronto (ON): Registered Nurses Association of Ontario (RNAO); 2005 Mar. 112 p.
Keywords
diabetes, ulcers, diabetic ulcers, diabetic dermal ulcer, diabetic dermal wound, diabetic foot wound, diabetic neuropathic ulceration, intractable plantar wound, neuropathic ulceration, neuropathic wound, silver dressings






Multimedia: Diabetic Ulcers