Review paper: basic concepts to novel therapies: a review of the diabetic foot.
Diabetes mellitus is a global epidemic. Peripheral neuropathy and peripheral vascular disease are complications of diabetes mellitus and the primary causative factors for foot ulceration. Foot ulceration is the leading cause of hospitalization in people with diabetes mellitus. The burden of foot ulceration on health care systems and individual patients is immense. Despite conventional treatment, there persists a high incidence of amputation. A multidisciplinary approach is required to prevent ulcers. This review describes the etiology and risk factors for diabetic foot ulceration and a system for evaluating the diabetic foot. The assessment of neuropathy and the grading of foot ulcers are critically examined. This is important to allow for standardization in clinical trials. The management of diabetic foot syndrome is reviewed. The treatments to ensure vascular supply to the lower limb and control of infection as well as novel therapies, which are becoming available to treat nonhealing, "no-option" diabetic ulcers, are discussed.
O'Loughlin
Aonghus
A
National University of Ireland, Galway, Ireland.
McIntosh
Caroline
C
Dinneen
Sean F
SF
O'Brien
Timothy
T
D000671:Amputation, Surgical; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001458:Bandages; D003646:Debridement; D017719:Diabetic Foot / Q000150:complications / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D003929:Diabetic Neuropathies; D005528:Foot / Q000098:blood supply*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007249:Inflammation / Q000188:drug therapy; D007511:Ischemia / Q000517:prevention & control; D012307:Risk Factors; D033581:Stem Cell Transplantation; D023822:Tissue Engineering
D000893:Anti-Inflammatory Agents