Article

Hospital-based studies have shown that mortality rates in individuals
with diabetic foot ulcers are about twice those observed in individuals with
diabetes without foot ulcers. OBJECTIVE: To assess the etiology and management of
chronic diabetic foot ulcers. METHODS: Systematic review of the literature discussing management of diabetic foot
ulcers. Since there were only a few randomized controlled trials on this topic,
articles were selected to attempt to be comprehensive rather than a formal
assessment of study quality. RESULTS: Chronic nonhealing foot ulcers occur in
approximately 15% of patients with diabetes. Many factors contribute to impaired
diabetic wound healing. Risk factors include peripheral neuropathy, peripheral
arterial disease, limited joint mobility, foot deformities, abnormal foot
pressures, minor trauma, a history of ulceration or amputation, and impaired
visual acuity. With the current treatment for nonhealing diabetic foot ulcers, a
significant number of patients require amputation. CONCLUSION: Diabetic foot
ulcers are optimally managed by a multidisciplinary integrated team. Offloading
and preventative management are important. Dressings play an adjunctive role.
There is a critical need to develop novel treatments to improve healing of
diabetic foot ulcers. The goal is to have wounds heal and remain healed. CLINICAL RELEVANCE: Diabetic neuropathy and peripheral arterial disease are major factors
involved in a diabetic foot ulcer. Despite current treatment modalities for
nonhealing diabetic foot ulcers, there are a significant number of patients who
require amputations. No known therapy will be effective without concomitant
management of ischemia, infection, and adequate offloading.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS