title: Diabetic foot disorders. A clinical practice guideline. For the American College of Foot and Ankle Surgeons and the American College of Foot and Ankle Orthopedics and Medicine.
abstract: Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot complications of diabetes mellitus that can too frequently lead to gangrene and lower limb amputation. Consequently, foot disorders are one of the leading causes of hospitalization for persons with diabetes and can account for expenditures in the billions of dollars annually in the U.S. alone. Although not all foot complications can be prevented, dramatic reductions in their frequency have been obtained through the implementation of a multidisciplinary team approach to patient management. Using this concept, the authors present a Clinical Practice Guideline for diabetic foot disorders based on currently available evidence. The underlying pathophysiology and treatment of diabetic foot ulcers, infections, and the diabetic Charcot foot are thoroughly reviewed. Although these guidelines cannot and should not dictate the standard of care for all affected patients, they are intended to provide evidence-based guidance for general patterns of practice. The goal of a major reduction in diabetic limb amputations is certainly possible if these concepts are embraced and incorporated into patient management protocols.
authors.affiliation: Des Moines University, 3200 Grand Ave., Des Moines, IA 50312, USA. robert.frykberg@dmu.edu
authors.forename: R G
authors.initials: RG
authors.lastname: Frykberg
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: J
authors.initials: J
authors.lastname: Giurini
authors.forename: A
authors.initials: A
authors.lastname: Edwards
authors.forename: M
authors.initials: M
authors.lastname: Kravette
authors.forename: S
authors.initials: S
authors.lastname: Kravitz
authors.forename: C
authors.initials: C
authors.lastname: Ross
authors.forename: J
authors.initials: J
authors.lastname: Stavosky
authors.forename: R
authors.initials: R
authors.lastname: Stuck
authors.forename: J
authors.initials: J
authors.lastname: Vanore
mesh_terms: D001177:Arthropathy, Neurogenic / Q000209:etiology / Q000628:therapy; D019091:Critical Pathways; D017719:Diabetic Foot / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D010348:Patient Care Team; D011032:Podiatry / Q000592:standards; D012307:Risk Factors; D014481:United States