• 1

    Lavery LA, Ashry HR, van Houtum W, et al: Variation in the incidence and proportion of diabetes-related amputations in minorities. .Diabetes Care 19::48. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Reiber GE, Boyko EJ, Smith DG: “Lower Extremity Foot Ulcers and Amputation in Diabetes,” in Diabetes in America, 2nd Ed, ed by MI Harris, CC Cowie, GE Reiber, et al, p 409, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, 1995..

  • 3

    Apelqvist J, Larsson J, Agardh CD: Long-term prognosis for diabetic patients with foot ulcers. .J Intern Med 223::485. ,1993. .

  • 4

    Armstrong DG, Lavery LA, Harkless LB: Who is at risk for diabetic foot ulceration. ?Clin Podiatr Med Surg 15::11. ,1998. .

  • 5

    Pecoraro RE, Reiber GE, Burgess EM: Pathways to diabetic limb amputation: basis for prevention. .Diabetes Care 13::513. ,1990. .

  • 6

    Reiber GE: Who is at risk of limb loss and what to do about it. ?J Rehabil Res Dev 31::357. ,1994. .

  • 7

    Pinzur MS, Stuck R, Sage R, et al: Benchmark analysis on diabetics at high risk for lower extremity amputation. .Foot Ankle Int 17::695. ,1996. .

  • 8

    Mayfield JA, Reiber GE, Nelson RG, et al: A foot risk classification system to predict diabetic amputation in Pima Indians. .Diabetes Care 19::704. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Weaver FM, Burdi MD, Pinzur MS: Outpatient foot care: correlation to amputation level. .Foot Ankle Int 15::498. ,1994. .

  • 10

    Boulton AJM, Hardisty CA, Betts RP, et al: Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy. .Diabetes Care 6::26. ,1983. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Murray HJ, Young MJ, Hollis S, et al: The association between callus formation, high pressures and neuropathy in diabetic foot ulceration. .Diabet Med 13::979. ,1996. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Reiber GE, Vileik L, Boyko EJ, et al: Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. .Diabetes Care 22::157. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Veves A, Murray HJ, Young MJ, et al: The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. .Diabetologia 35::660. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Young MJ, Cavanagh PR, Thomas G, et al: The effect of callus removal on dynamic plantar foot pressures in diabetic patients. .Diabet Med 9::55. ,1992. .

  • 15

    Wagner FW: “The Insensitive Foot,” in AAOS Symposium of the Foot and Ankle, ed by RH Kiene, KA Johnson, p 135, CV Mosby, St Louis, MO, 1981..

  • Bauman JH, Girling JP, Brand PW: Plantar pressures and trophic ulceration: an evaluation of footwear. .J Bone Joint Surg Br 45::552. ,1963. .

    • PubMed
    • Search Google Scholar
  • Mayfield JA, Reiber GE, Sanders LJ, et al: Preventive foot care in people with diabetes. .Diabetes Care 21::2161. ,1998. .

    • PubMed
    • Search Google Scholar
  • Ramsey SD, Newton K, Blough D, et al: Incidence, outcomes, and cost of foot ulcers in patients with diabetes. .Diabetes Care 22::382. ,1999. .

    • PubMed
    • Search Google Scholar

Outpatient Care and Morbidity Reduction in Diabetic Foot Ulcers Associated with Chronic Pressure Callus

View More View Less
  • 1 Professor, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Stritch School of Medicine, 2160 S First Ave, Maywood, IL 60153.
  • | 2 Submitted during fourth year, William M. Scholl College of Podiatric Medicine, Chicago, IL.
  • | 3 Assistant Professor of Epidemiology and Biostatistics, Loyola University Stritch School of Medicine, Maywood, IL.
Restricted access

In a retrospective review of 233 cases of diabetic foot ulceration preceded by minor trauma, 192 ulcerations exhibited focal pressure keratosis as the preceding traumatic event. The frequency of outpatient visits and other foot care interventions were correlated with the occurrence and severity of ulceration. Patients seen more frequently in an outpatient foot clinic had less severe ulcers and were less likely to undergo surgical treatment than those with less frequent visits. (J Am Podiatr Med Assoc 91(6): 275-279, 2001)