Armstrong DG, Peters EJG, Athanasiou KA, et al: Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration. ?J Foot Ankle Surg37::303. ,1998. .9710782)| false
Steed DL, Donohoe D, Webster MW, et al, for the Diabetic Ulcer Study Group: Effect of extensive debridement and treatment on the healing of diabetic foot ulcers. .J Am Coll Surg183::61. ,1996. .8673309)| false
How and Why to Surgically Debride Neuropathic Diabetic Foot Wounds
David G. Armstrong
David G. ArmstrongDirector of Research and Education, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson; Visiting Senior Lecturer of Medicine, Department of Medicine, Manchester Royal Infirmary, Manchester, England. Mailing address:Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, 3601 S Sixth Ave, Tucson, AZ 85723.
Wound debridement, when systematically performed, may be as important as off-loading in reducing the prevalence of chronic inflammatory by-products in a wound and thus in converting a chronic wound into an acute one. Although it has been suggested that aggressive surgical debridement of wounds may be beneficial, there have been few, if any, technical descriptions of this aspect of therapy. It is therefore the purpose of this article to describe the general principles, process, and technique of outpatient surgical debridement of noninfected, nonischemic neuropathic diabetic foot wounds performed at the authors’ institutions. The authors hope to foster further discussion leading to improvement in the process and the prevalence of such debridement. (J Am Podiatr Med Assoc 92(7): 402-404, 2002)