Diabetic Foot Ulcers Questions & Answers

Updated: Jan 22, 2020
  • Author: Vincent Lopez Rowe, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Questions & Answers

Overview

What are diabetic ulcers?

How do nonenzymatic glycation and neuropathy cause diabetic ulcers?

What is the prognosis of diabetic ulcers?

What is involved in the physical exam of diabetic ulcers?

How are diabetic ulcers staged?

What are the treatment options for diabetic ulcers?

Which specialists should be consulted in the management of diabetic ulcers?

When is cilostazol contraindicated in the treatment of diabetic ulcers?

What are the medical conditions that cause diabetic ulcers?

What is the pathogenesis of atherosclerosis in diabetic ulcers?

Why is atherosclerosis prevalent in diabetic ulcers?

What is the pathophysiology of peripheral neuropathy in diabetic ulcers?

What are the etiologies of diabetic ulcers?

What is the role of tissue mechanics in the etiology of diabetic ulcers?

What is the role of anatomy in the etiology of diabetic ulcers?

What is the role of sensory neuropathy in the etiology of diabetic ulcers?

How does Charcot foot cause diabetic ulcers?

What is the incidence of diabetic ulcers?

How does the incidence of diabetic ulcers vary by age?

What are the racial predilections of diabetic ulcers?

What causes mortality in patients with diabetic ulcers?

What is the prognosis of diabetic ulcers?

What is the recurrence rate for diabetic ulcers?

What is the primary cause of premature death in patients with diabetic ulcers?

How does invasive systemic infection affect mortality risk in diabetic ulcers?

What information about diabetic ulcers should patients receive?

Presentation

What should be the focus of the history of patients with diabetic ulcers?

What are the symptoms of peripheral neuropathy in patients with diabetic ulcers?

What are some manifestations of peripheral arterial insufficiency in diabetic ulcers?

What are the signs of peripheral arterial insufficiency in asymptomatic patients with diabetic ulcers?

What are the signs and symptoms of claudication in patients with diabetic ulcers?

What are the first signs that loss of perfusion has occurred in diabetic ulcers?

What is included in the physical exam of the extremity in suspected diabetic ulcer?

Why is a comprehensive physical exam important in patients with diabetic ulcers?

Where are diabetic ulcers most likely to occur?

Which physical findings suggest diabetic ulcers?

Which peripheral pulse finding suggests diabetic ulcers?

Which findings suggest peripheral arterial insufficiency in patients with diabetic ulcers?

Which physical findings suggest peripheral neuropathy in patients with diabetic ulcers?

DDX

Which conditions should be included in the differential diagnoses of diabetic ulcers?

What are the differential diagnoses for Diabetic Foot Ulcers?

Workup

What testing is included in the workup of diabetic ulcers, and what are the assessment guidelines?

What is the role of blood tests in the diagnosis of diabetic ulcers?

What is the role of pulse-volume recording (PVR) in the diagnosis of diabetic ulcers?

What is the role of ultrasonography in the diagnosis of diabetic ulcers?

What is the role of ankle-brachial index in the diagnosis of diabetic ulcers?

What is the role of radiography in the diagnosis of diabetic ulcers?

What is the role of CT scanning and MRI in the diagnosis of diabetic ulcers?

What is the role of bone scans in the diagnosis of diabetic ulcers?

What is the role of angiography in the diagnosis of diabetic ulcers?

How is angiography performed in the diagnosis of diabetic ulcers?

What are the possible complications of angiography for the diagnosis of diabetic ulcers?

What are contrast-related complications of angiography for the diagnosis of diabetic ulcers?

When using contrast angiography for diagnosis of diabetic ulcers what precautions are needed?

What is the role of carbon dioxide angiography in the diagnosis of diabetic ulcers?

What is the role of MRA in the diagnosis of diabetic ulcers?

What is the role of multidetector CT (MDCT) angiography in the diagnosis of diabetic ulcers?

What is the role of transcutaneous tissue oxygen studies in the diagnosis of diabetic ulcers?

How are diabetic ulcers staged?

Are tissue samples or wound swabs superior for pathogen identification in diabetic ulcers?

Treatment

How are diabetic ulcers managed?

What are the treatment options and guidelines for diabetic ulcers?

Which systemic factors must be managed in the treatment of diabetic ulcers?

What is the basic principle of topical wound management for diabetic ulcers?

How is wound management performed in the treatment of diabetic ulcers?

What are less commonly used topical preparations for the management of diabetic ulcers?

What is the role of cytotoxic agents in the treatment of diabetic ulcers?

What is the role of vacuum-assisted closure (VAC) in the treatment of diabetic ulcers?

What are the roles of hydrotherapy and extracorporeal shock-wave therapy in the treatment of diabetic ulcers?

How is Charcot foot treated in patients with diabetic ulcers?

What are the surgical options for diabetic ulcers?

What is the role of debridement in the treatment of diabetic ulcers?

What is the role of revisional surgery in the treatment of diabetic ulcers?

What is the role of vascular surgery in the treatment of diabetic ulcers?

What are the healing options following surgical intervention in diabetic ulcers?

What is the role of autologous skin graft in the treatment of diabetic ulcers?

What is the role of cadaveric skin allograft in the treatment of diabetic ulcers?

What is the role of Dermagraft in the treatment of diabetic ulcers?

What are the roles of Apligraf and allogeneic keratinocyte dressings in the treatment of diabetic ulcers?

What is the role of bioengineered skin substitutes for wound coverage in diabetic ulcers?

What is the role of Oasis in the treatment of diabetic ulcers?

What is required for delayed primary closure of diabetic ulcers?

What is the role of hyperbaric oxygen therapy in the treatment of diabetic ulcers?

Which dietary modification are needed in patients with diabetic ulcers?

Which activity modifications are needed in patients with diabetic ulcers?

How are diabetic ulcers prevented?

What is the role of hyperglycemia in the development of diabetic ulcers?

Which lifestyle changes may prevent diabetic ulcers?

Where can complete information regarding diabetic ulcers be found?

Which specialists should be consulted in the management of diabetic ulcers?

What is included in the long-term care of diabetic ulcers?

Medications

What is the role of medications in the treatment of diabetic ulcers?

Which medications in the drug class Wound Healing Agents are used in the treatment of Diabetic Foot Ulcers?

Which medications in the drug class Antiplatelet agents are used in the treatment of Diabetic Foot Ulcers?

Which medications in the drug class Hemorrheologic Agents are used in the treatment of Diabetic Foot Ulcers?