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Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Maggots in medical packaging. Maggot therapy improves healing in chronic ulcers. [1] In diabetic foot ulcers there is tentative evidence of benefit. [3] A Cochrane review of methods for the debridement of venous leg ulcers found maggot therapy to be broadly as effective as most other methods, but the study also noted that the quality of data was poor.
The underlying mechanism of diabetic foot infections often involves poor blood flow and peripheral neuropathy. Diagnosis is based on symptoms and may be supported by deep tissue culture. [2] Treatment involves proper wound care and antibiotics.
Total contact casting (TCC) is a specially designed cast designed to take weight off of the foot (off-loading) in patients with diabetic foot ulcers (DFUs). Reducing pressure on the wound by taking weight off the foot has proven to be very effective in DFU treatment. DFUs are a major factor leading to lower leg amputations among the diabetic ...
Debridement and drainage of wound fluid are an especially important part of the treatment for diabetic ulcers, which may create the need for amputation if infection gets out of control. Mechanical removal of bacteria and devitalized tissue is also the idea behind wound irrigation, which is accomplished using pulsed lavage. [14]
For treating diabetic ulcers of the feet, "consistent evidence of the benefit of NPWT" in the treatment of diabetic ulcers of the feet has been reported. [19] Results for bedsores were conflicting and research on mixed wounds was of poor quality, but promising. [19] There is no evidence of increased significant complications. [19]
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