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- Algorithm I—Management Guidelines for Septic Foot Wounds
- Algorithm II—Management Guidelines for Ischemic Foot Ulcers and Gangrene
- Step 1: Initial Assessment
- Step 2: Diagnostic Tests
- Step 3: Diabetes Mellitus Comorbidity Evaluation
- Step 4: Is Limb Salvage Vascular Surgery Considered?
- Step 5: Arteriovascular Studies
- Step 6: Determine Limb Salvageability
- Step 7: Limb Salvage Vascular Procedures
- Step 8: Debridement or Amputation of the Toes and Foot
- Step 9: Healing of the Wound
- Step 10: Care of the Nonsalvageable Foot
- Step 11: Care After Amputation or Resolution of the Wound
- Algorithm III—Management Guidelines for Neuropathic Foot Ulcers
- Step 1: Initial Assessment
- Step 2: Diagnostic Tests
- Step 3: Diabetes Mellitus Comorbidity Evaluation
- Step 4: Care of the Noninfected Neuropathic Ulcer
- Step 5: Care After Resolution of the Ulcer
- Management of Neuropathic Ulcers with Osteomyelitis
- Step 6: Hospital Admission
- Step 7: Medical Management of Osteomyelitis
- Step 8: Surgical Management of Osteomyelitis
- Step 9: Care of the Surgical Wound
- Step 10: Primary Closure of the Wound
- Step 11: Injury Prevention
- Conclusion
- Additional References
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Diabetic Foot Wound Care Algorithms
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The purpose of this article is to present reference guidelines to assist clinicians when treating diabetic patients with foot wounds. Diabetic patients with limb-threatening foot ulcers often have multiple coexisting medical conditions that frequently become impediments to the resolution of foot wounds. Each foot wound is unique and its etiology is multifactorial; therefore, each foot wound should be managed differently. The treatment algorithm presented in this article is divided into three categories: Algorithm I describes the treatment of septic foot wounds, which may be considered true podiatric surgical emergencies; Algorithm II describes the treatment of ischemic foot ulcers or gangrene with or without underlying osteomyelitis; and Algorithm III describes the treatment of neuropathic foot ulcers with or without underlying osteomyelitis. (J Am Podiatr Med Assoc 92(6): 336-349, 2002)
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