Despite a benign appearance, any foot injury occurring in a patient with diabetes requires multidisciplinary management if dreaded complications such as amputation are to be avoided. From a pathophysiological point of view, foot ulcer generally results from the combination of lower extremity neuropathy, mechanical overload, immunopathy and vascular insufficiency. The treatment associates in all cases an offloading and one or more debridements. Depending on the grade of the ulcer, adjuvant treatments, such as antibiotic therapy, revascularization, and hyperbaric oxygen therapy may be indicated.
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JACC Cardiovasc Interv
December 2024
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
J Wound Care
January 2025
Nursing and Health Care, School of Health Sciences, South East Technological University, Waterford City, Ireland.
Objective: Wound management can be costly and challenging to the health services' scarce resources. Information regarding the number of wounds in a community care setting and their associated aetiology will provide nurses and nurse managers with an insight into the specific needs of these clients with wounds and highlight areas where care or services can be improved or further developed. This research aimed to establish the prevalence and aetiology of wounds, the current delivery of wound care, wound documentation and referral pathways in an Irish community care setting.
View Article and Find Full Text PDFJ Foot Ankle Res
March 2025
The University of South Australia, Allied Health & Human Performance Unit, Adelaide, SA, Australia.
Background: This study investigated the effect of various offloading devices commonly used for the management of diabetic foot ulcerations on peak plantar pressure and pressure-time integral of the contralateral limb.
Methods: A quantitative, randomised and within-subject repeated measures study was conducted in an outpatient gait laboratory. Outpatients with unilateral diabetic foot ulcers and adequate perfusion to the lower limb without an intrinsic limb-length discrepancy who were able to walk were recruited for the study.
J Biomech
January 2025
Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9 1105 AZ, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
The offloading effectiveness of custom-made footwear for people with diabetes is assessed using plantar pressure measurements. While such pressure data is multidimensional, it is mostly analyzed using a scalar - maximum peak plantar pressure (PMax). We aimed to investigate the associations between multiple peak plantar pressure parameters for footwear assessment and determine whether this assessment depends on the chosen parameter.
View Article and Find Full Text PDFSurgery
January 2025
Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, China. Electronic address:
Objective: This randomized controlled trial aimed to compare the efficacy of negative-pressure wound therapy with advanced moist wound therapy in managing diabetic foot ulcers.
Methods: A total of 450 participants with diabetic foot ulcers were randomized to receive either negative-pressure wound therapy (n = 204) or advanced moist wound therapy (n = 246) over 18 months. The primary outcome was complete ulcer closure, with secondary outcomes including time to closure, wound size reduction, infection rates, recurrence, and amputation rates.
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