Diabetic foot ulcers and vascular insufficiency: our population has changed, but our methods have not.
Diabetic foot complications are increasing in prevalence worldwide. Care and attention to these complications have improved greatly. Many advanced therapies are now being investigated or taken through final stages of clinical studies worldwide. However, the data upon which assumptions regarding morbidity, healing, and mortality have been based are grossly outdated. The purpose of this brief article is to report on current data regarding neuropathic and neuroischemic wounds and to propose that the latter category of advanced-stage diabetic foot wound may now be emerging as the most commonly encountered lesion in the developed world. Unfortunately, it is still systematically excluded from most clinical study criteria. Additionally, just as in the care of cancer, we call for therapy of these advanced-stage diabetic foot ulcers to be managed in similarly interdisciplinary centers where patients may have access to potentially beneficial clinical trials.
Southern Arizona Limb Salvage Alliance, University of Arizona College of Medicine, Tucson, Arizona 85724 , USA.
David G
DG
Armstrong
Kelman
K
Cohen
Stephane
S
Courric
Manish
M
Bharara
William
W
Marston
D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D017719:Diabetic Foot / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy