Internal Med Medical News about Diabetic Foot Ulcer

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Exploring the complex care of the diabetic foot ulcer
JAAPA, 10/26/09

Jones R – Many amputations resulting from diabetic foot ulcers are preventable with a thorough evaluation and aggressive treatment. The most important primary preventive measures are properly fitting socks and shoes and good control of blood glucose and lipid levels and of BP. A comprehensive, multidisciplinary evaluation, including determination of etiology, is essential in treating the diabetic foot ulcer. The primary objective is to heal the ulcer and prevent amputation. Patients with an infected foot ulcer benefit from early, aggressive treatment that encompasses debridement, good wound care, and pressure relief. An infected diabetic foot ulcer requires close supervision whether it is limb threatening or not. A radiograph of the foot is acceptable initially, but a technetium scan or MRI may be warranted to confirm the clinical assessment. Antibiotic coverage should be broad spectrum and tailored to the patient.