Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Endocrine
Published in: Endocrine 3/2012

01-06-2012 | Review

Diagnostics and treatment of the diabetic foot

Author: Jan Apelqvist

Published in: Endocrine | Issue 3/2012

Login to get access

Abstract

Every 30 s, a lower limb is amputated due to diabetes. Of all amputations in diabetic patients 85% are preceded by a foot ulcer which subsequently deteriorates to a severe infection or gangrene. There is a complexity of factors related to healing of foot ulcers including strategies for treatment of decreased perfusion, oedema, pain, infection, metabolic disturbances, malnutrition, non-weight bearing, wound treatment, foot surgery, and management of intercurrent disease. Patients with diabetic foot ulcer and decreased perfusion do often not have rest pain or claudication and as a consequence non-invasive vascular testing is recommended for early recognition of ulcers in need of revascularisation to achieve healing. A diabetic foot infection is a potentially limb-threatening condition. Infection is diagnosed by the presence or increased rate of signs inflammation. Often these signs are less marked than expected. Imaging studies can diagnose or better define deep, soft tissue purulent collections and are frequently needed to detect pathological findings in bone. The initial antimicrobial treatment as well as duration of treatment is empiric. There is a substantial delay in wound healing in diabetic foot ulcer which has been related to various abnormalities. Several new treatments related to these abnormalities have been explored in wound healing with various successes. An essential part of the strategy to achieve healing is an effective offloading. Many interventions with advanced wound management have failed due to not recognizing the need for effective offloading. A multidisciplinary approach to wounds and foot ulcer has been successfully implemented in different centres with a substantial decrease in amputation rate.
Literature
1.
A.J. Boulton, L. Vileikyte, G. Ragnarson-Tennvall, J. Apelqvist, The global burden of diabetic foot disease. Lancet 366(9498), 1719–1724 (2005)PubMedCrossRef
2.
International Working Group on the Diabetic Foot, International consensus on the diabetic foot and practical guidelines on the management and the prevention of the diabetic foot. Amsterdam, the Netherlands (2011). Available on CD-ROM at www.​idf.​org/​bookshop or (www.​diabeticfoot.​nl)
3.
J. Apelqvist, K. Bakker, W.H. van Houtum, International Working Group on the Diabetic Foot (IWGDF) Editorial Board, Practical guidelines on the management and prevention of the diabetic foot: based upon the International Consensus on the Diabetic Foot (2007) prepared by the International Working Group on the Diabetic Foot. Diabetes Metab. Res. Rev. 24(Suppl 1), S181–S187 (2008)PubMedCrossRef
4.
S. Tesfaye, A.J.M. Boulton, P.J. Dyck, R. Freeman, M. Horowitz, P. Kempler et al., Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33(10), 2285–2293 (2010)PubMedCrossRef
5.
E.J. Boyko, J.H. Ahtoni, V. Stensel, R.C. Forsberg, D.R. Davignon, D.G. Smith, A prospecticve study for risk factors for diabetic ulcer. The Seattle Diabetic Foot Study. Diabetes Care 22, 1036–1042 (1999)PubMedCrossRef
6.
C.A. Abbott, A.L. Carrington, H. Ashe, S. Bath, L.C. Every, J. Griffiths et al., The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabet. Med. 19, 377–384 (2002)PubMedCrossRef
7.
N. Singh, D.G. Amstrong, B.A. Lipsky, Preventing foot ulcers in patients with diabetes. JAMA 293, 217–228 (2005)PubMedCrossRef
8.
E.J. Boyko, J.H. Ahroni, V. Cohen, K.M. Nelson, P.J. Heagerty, Prediction of diabetic ulcer occurrence using commonly available clinical information. The Seattle Diabetic Foot Study. Diabetes Care 29, 1202–1207 (2006)PubMedCrossRef
9.
A.J. Boulton, The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab. Res. Rev. 24(Suppl 1), S3–S6 (2008)PubMedCrossRef
10.
J. Apelqvist, J. Larsson, What is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab. Res. Rev. 16(Suppl 1), S75–S83 (2000)PubMedCrossRef
11.
W. Jeffcoate, F. Game, P. Cavanagh, The role of proinflammatory cytokines in the cause of neuropathic osteoartropathy (acute Charcot foot) in diabetes. Lancet 366, 2058–2061 (2005)PubMedCrossRef
12.
E. Trepman, A. Nihal, M. Pinzur, Charcot neuroarthropathy of the foot and ankle. Foot Ankle Int. 26, 46–63 (2005)PubMed
13.
L. Prompers, N. Schaper, J. Apelqvist, M. Edmonds, E. Jude, D. Mauricio et al., Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE study. Diabetologia 51(5), 747–755 (2008)PubMedCrossRef
14.
L. Prompers, M. Huijberts, J. Apelqvist, E. Jude, A. Piaggesi, K. Bakker, M. Edmonds, P. Holstein, A. Jirkovska, D. Mauricio, G. Ragnarson Tennvall, H. Reike, M. Spraul, L. Uccioli, V. Urbancic, K. Van Acker, J. van Baal, F. van Merode, High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia 50, 18–25 (2007)PubMedCrossRef
15.
L. Prompers, M. Huijberts, J. Apelqvist, E. Jude, A. Piaggesi, K. Bakker, M. Edmonds, P. Holstein, A. Jirkovska, D. Mauricio, G.R. Tennvall, H. Reike, M. Spraul, L. Uccioli, V. Urbancic, K. Van Acker, J. Van Baal, F. Van Merode, N. Schaper, Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale study, a prospective cohort study. Diabet. Med. 25, 700–707 (2008)PubMedCrossRef
16.
M.A. Gershater, M. Löndahl, P. Nyberg, J. Larsson, J. Thörne, M. Eneroth, J. Apelqvist, Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study. Diabetologia 52(3), 398–407 (2009)PubMedCrossRef
17.
N.C. Schaper, M.H. Nabuurs-Franssen, S.P. Huijberts, Peripheral vascular disease and type 2 diabetes mellitus. Diabetes Metab. Res. Rev. 16(Suppl 1), S11–S15 (2000)PubMedCrossRef
18.
F.W. LoGerfo, J.D. Coffman, Current concepts. Vascular and microvascular disease of the foot in diabetes. Implications for foot care. N. Engl. J. Med. 311, 1615–1619 (1984)PubMedCrossRef
19.
G. Jörneskog, K. Brismar, B. Fagrell, Pronounced skin capillary ischemia in the feet of diabetic patients with bad metabolic control. Diabetologia 41(4), 410–415 (1998)PubMedCrossRef
20.
N.C. Schaper, M. Huijberts, K. Pickwell, Neurovascular control and neurogenic inflammation in diabetes. Diabetes Metab. Res. Rev. 24(suppl 1), S40–S44 (2008)PubMedCrossRef
21.
M.S. Ruiter, J.M. van Golde, N.C. Schaper, C.D. Stehouwer, M.S. Huijberts, Diabetes impairs arteriogenesis in the peripheral circulation: review of molecular mechanisms. Clin. Sci. (Lond.) 119(6), 225–238 (2010)CrossRef
22.
C. Gazzaruso, A. Coppola, M. Montalcini, E. Baffero, A. Garzaniti, G.G. Pelissero, S. Collaviti, A. Grugnetti, P. Gallotti, A. Pujia, S.B. Solerte, A. Giustina, Lipoprotein(a) and homocysteine as genetic risk factors for vascular and neuropathic diabetic foot in type 2 diabetes mellitus. Endocrine 41, 89–95 (2012)PubMedCrossRef
23.
L. Prompers, M. Huijberts, J. Apelqvist, E. Jude, A. Piaggesi, K. Bakker et al., Optimal organization of health care in diabetic foot disease: introduction to the Eurodiale study. Int. J. Low Extrem. Wounds 6(1), 11–17 (2007)PubMedCrossRef
24.
S. Krishnan, F. Nash, N. Baker, D. Fowler, G. Rayman, Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit. Diabetes Care 31, 99–101 (2008)PubMedCrossRef
25.
W.H. van Houtum, J.A. Rauwerda, D. Ruwaard, N.C. Schaper, K. Bakker, Reduction in diabetes-related lower-extremity amputations in the Netherlands: 1991–2000. Diabetes Care 27, 1042–1046 (2004)PubMedCrossRef
26.
J. Larsson, J. Apelqvist, C.D. Agardh, A. Stenström, Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach? Diabet. Med. 12, 770–776 (1995)PubMedCrossRef
27.
K. Aydin, M. Isildak, J. Karakaya, A. Gurlek, Change in amputation predictors in diabetic foot disease: effect of multidisciplinary approach. Endocrine 38, 87–92 (2010)PubMedCrossRef
28.
M. Luther, I. Kantonen, M. Lepantalo, FINNVASC Study Group, Arterial intervention and reduction in amputation for chronic critical leg ischaemia. Br. J. Surg. 87, 454–458 (2000)PubMedCrossRef
29.
H. Zayed, M. Halawa, L. Maillardet, P.S. Sidhu, M. Edmonds, H. Rashid, Improving limb salvage rate in diabetic patients with critical leg ischaemia using a multidisciplinary approach. Int. J. Clin. Pract. 63(6), 855 (2009)PubMedCrossRef
30.
31.
International Working Group on the Diabetic Foot (IWGDF) Editorial Board, The diabetic foot. Diabetes Metab. Res. Rev. 24(Suppl 1), S1–S193 (2008)
32.
P.R. Cavanagh, B.A. Lipsky, A.W. Bradbury, G. Botek, Treatment for diabetic foot ulcers. Lancet 366(9498), 1725–1735 (2005)PubMedCrossRef
33.
34.
35.
D. Steed, C. Attinger, T. Colaizzi, M. Crossland, M. Franz, L. Harkless et al., Guidelines for the treatment of diabetic ulcers. Wound Repair Regen. 14, 680–692 (2006)PubMedCrossRef
36.
S. Vuorisalo, M. Venermo, M. Lepäntalo, Treatment of diabetic foot ulcers. J. Cardiovasc. Surg. 50(3), 275–291 (2009)
37.
R. Fontaine, M. Kim, R. Kieny, Surgical treatment of peripheral circulation disorders. Helv. Chir. Acta 21, 499–533 (1954)PubMed
38.
P.R.F. Bell, D. Charlesworth, R.G. DePalma, H.H.G. Eastcott, B. Eklöf, J.D. Gruss, C.W. Jamieson, P.J. Morris, A.N. Nicolaides, R.B. Rutherford, The definition of critical iscaemia of a limb. Br. J. Surg. 69, 22 (1982)
39.
Suggested standards for reports dealing with lower extremity ischemia, Prepared by the Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery/North American Chapter, International Society for Cardiovascular Surgery. J. Vasc. Surg. 4(1), 80–94 (1986)
40.
Second European consensus document on chronic critical leg ischaemia. Eur. J. Vasc. Surg. 6(suppl A), 1–32 (1992)
41.
R.B. Rutherford, J.D. Baker, C. Ernst, K.W. Johnston, J.M. Porter, S. Ahn, D.N. Jones, Recommended standards for reports dealing with lower extremity ischemia: revised version. J. Vasc. Surg. 26(3), 517–538 (1997)PubMedCrossRef
42.
L. Norgren, W.R. Hiatt, J.A. Dormandy, on behalf of the TASC II Working Group, Inter-society consensus for the management of peripheral arterial disease (TASC II). J. Vasc. Surg. 45(Suppl), S5–S67 (2007)PubMedCrossRef
43.
Management of peripheral arterial disease (PAD), Transatlantic inter-society consensus (TASC). Eur. J. Vasc. Endovasc. Surg. 19(Suppl A), S1–S250 (2000)
44.
N.C. Schaper, Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab. Res. Rev. 20(Suppl 1), 90–95 (2004)CrossRef
45.
D.G. Armstrong, L.A. Lavery, L.B. Harkless, Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 21(5), 855–859 (1998)PubMedCrossRef
46.
S. Beckert, M. Witte, C. Wicke et al., A new wound-based severity score for diabetic foot ulcers. Diabetes Care 29(5), 988–992 (2006)PubMedCrossRef
47.
N.C. Schaper, G. Andros, J. Apelqvist, K. Bakker, J. Lammer, M. Lepantalo, J.L. Mills, J. Reekers, C.P. Shearman, R.E. Zierler, R.J. Hinchliffe, Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot. Diabetes Metab. Res. Rev. 28(Suppl 1), 218–224 (2012)
48.
S.R. McGee, E.J. Boyko, Physical examination and chronic lower-extremity ischemia: a critical review. Arch. Intern. Med. 158(12), 1357 (1998)PubMedCrossRef
49.
N.C. Schaper, G. Andros, J. Apelqvist, K. Bakker, J. Lammer, M. Lepantalo, J.L. Mills, J. Reekers, C.P. Shearman, R.E. Zierler, R.J. Hinchliffe, Specific guidelines for the diagnosis and treatment of peripheral arterial disease in a patient with diabetes and ulceration of the foot. Diabetes Metab. Res. Rev. 28(Suppl 1), 236–237 (2012)
50.
M. Lundin, J.P. Wiksten, T. Peräkylä, O. Lindfors, H. Savolainen, J. Skyttä et al., Distal pulse palpation: is it reliable? World J. Surg. 23, 252–255 (1999)PubMedCrossRef
51.
J. Apelqvist, J. Larsson, C.-D. Agardh, The importance of peripheral pulses, peripheral oedema and local pain for the outcome of diabetic foot ulcers. Diabet. Med. 7, 590–594 (1990)PubMedCrossRef
52.
G. Andros, R.W. Harris, L.B. Dulawa, R.W. Oblath, S.X. Salles-Cunha, The need for arteriography in diabetic patients with gangrene and palpable foot pulses. Arch. Surg. 119(11), 1260–1263 (1984)PubMedCrossRef
53.
E.J. Boyko, J.H. Ahroni, D. Davignon, V. Stensel, R.L. Prigeon, D.G. Smith, Diagnostic utility of the history and physical examination for peripheral vascular disease among patients with diabetes mellitus. J. Clin. Epidemiol. 50(6), 659–668 (1997)PubMedCrossRef
54.
A.M. O’Hare, R. Katz, M.G. Shilipak, M. Cushman, A.B. Newman, Mortality and cardiovascular risk across ankle-arm index spectrum: results from the Cardiovascular Health Study. Circulation 113, 388–393 (2006)PubMedCrossRef
55.
V. Aboyans, E. Ho, J.O. Denenberg, L.A. Ho, L. Natarajan, M.H. Criqui, The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects. J. Vasc. Surg. 48, 1197–1203 (2008)PubMedCrossRef
56.
J. Apelqvist, J. Castenfors, J. Larsson, A. Stenstrom, C.D. Agardh, Prognostic value of systolic ankle and toe blood pressure levels in outcome of diabetic foot ulcer. Diabetes Care 12, 373–378 (1989)PubMedCrossRef
57.
P. Holstein, The distal blood pressure predicts healing of amputations on the feet. Acta Orthop. Scand. 55, 227–233 (1984)PubMedCrossRef
58.
J.L. Ballard, C.C. Eke, T.J. Bunt, J.D. Killeen, A prospective evaluation of transcutaneous oxygen measurements in the management of diabetic foot problems. J. Vasc. Surg. 22, 485–490 (1995)PubMedCrossRef
59.
E. Faglia, G. Clerici, M. Caminiti, A. Quarantiello, V. Curci, A. Morabito, Predictive values of transcutaneous oxygen tension for above-the-ankle amputation in diabetic patients with critical limb ischemia. Eur. J. Vasc. Endovasc. Surg. 33, 731–736 (2007)PubMedCrossRef
60.
E. Lukkari-Rautiarinen, M. Lepäntalo, J. Pietilä, Reproducibility of skin blood flow, perfusion pressure and oxygen tension measurements in advanced lower limb ischaemia. Eur. J. Vasc. Surg. 3, 345–350 (1989)PubMedCrossRef
61.
M.S. Pinzur, R. Stuck, R. Sage, H. Osterman, Transcutaneous oxygen tension in the dysvascular foot with infection. Foot Ankle 14, 254–256 (1993)PubMed
62.
E.J. Boyko, J.H. Ahroni, V.L. Stensel, D.G. Smith, D.R. Davignon, R.E. Pecoraro, Predictors of transcutaneous oxygen tension in the lower limbs of diabetic subjects. Diabet. Med. 13, 549–554 (1996)PubMedCrossRef
63.
W.B. Kannel, D.L. McGee, Update on some epidemiologic features of intermittent claudication: the Framingham Study. J. Am. Geriatr. Soc. 33(1), 13–18 (1985)PubMed
64.
W.A. Marston, S.W. Davies, B. Armstrong, M.A. Farber, R.C. Mendes, J.J. Fulton et al., Natural history of limbs with arterial insufficiency and chronic ulceration treated without revascularization. J. Vasc. Surg. 44(1), 108–114 (2006)PubMedCrossRef
65.
A. Karthikesalingam, P.J. Holt, P. Moxey, K.G. Jones, M.M. Thompson, R.J. Hinchliffe, A systematic review of scoring systems for diabetic foot ulcers. Diabet. Med. 27(5), 544–549 (2010)PubMedCrossRef
66.
J.K. Raines, R.C. Darling, J. Buth, D.C. Brewster, W.G. Austen, Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. Surgery 79, 21–29 (1976)PubMed
67.
R. Takolander, J.A. Rauwerda, The use of noninvasive vascular assessment in diabetic patients with foot lesions. Diabet. Med. 13(suppl 1), S39–S42 (1995)
68.
G.L. Moneta, R.A. Yeager, R.W. Lee, J.M. Porter, Noninvasive localization of arterial occlusive disease: a comparison of segmental Doppler pressures and arterial duplex mapping. J. Vasc. Surg. 17, 578–582 (1993)PubMedCrossRef
69.
F.T. Padberg, T.L. Back, P.N. Thompson, R.W. Hobson II, Transcutaneous oxygen (TcPO2) estimates probability of healing in the ischemic extremity. J. Surg. Res. 60, 365–369 (1996)PubMedCrossRef
70.
L. Graziani, A. Silvestro, V. Bertone, E. Manara, R. Andreini, A. Sigala, R. Mingardi, R. De Giglio, Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur. J. Vasc. Endovasc. Surg. 33(4), 453–460 (2007)PubMedCrossRef
71.
K.A. Arsenault, J. McDonald, P.J. Devereaux, K. Thorlund, J.G. Tittley, R.P. Whitlock, The use of transcutaneous oximetry to predict complications of chronic wound healing: a systematic review and meta-analysis. Wound Repair Regen. 19, 657–663 (2011)PubMedCrossRef
72.
J.L. Mills Sr, Open bypass and endoluminal therapy: complementary techniques for revascularization in diabetic patients with critical limb ischaemia. Diabetes Metab. Res. Rev. 24(Suppl 1), S34–S39 (2008)PubMedCrossRef
73.
F. Pomposelli, Arterial imaging in patients with lower extremity ischemia and diabetes mellitus. J. Vasc. Surg. 52(3 Suppl), 81S–91S (2010)PubMedCrossRef
74.
R. Collins, J. Burch, G. Cranny, R. Aguiar-Ibáñez, D. Craig, K. Wright, E. Berry, M. Gough, J. Kleijnen, M. Westwood, Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review. BMJ 334(7606), 1257 (2007)PubMedCrossRef
75.
R. Met, S. Bipat, D.A. Legemate, J.A. Reekers, M.J. Koelemay, Diagnostic performance of computed tomography angiography in peripheral arterial disease: a systematic review and meta-analysis. JAMA 301, 415–424 (2009)PubMedCrossRef
76.
M.H. Heijenbrok-Kal, M.C. Kock, M.G. Hunink, Lower extremity arterial disease: multidetector CT angiography meta-analysis. Radiology 245, 433–439 (2007)PubMedCrossRef
77.
D.J. Dinter, K.W. Neff, G. Visciani, R. Lachmann, C. Weiss, S.O. Schoenberg, H.J. Michaely, Peripheral bolus-chase MR angiography: analysis of risk factors for nondiagnostic image quality of the calf vessels—a combined retrospective and prospective study. AJR Am. J. Roentgenol. 193, 234–240 (2009)PubMedCrossRef
78.
G. Andreisek, T. Pfammatter, K. Goepfert, D. Nanz, P. Hervo, R. Koppensteiner, D. Weishaupt, Peripheral arteries in diabetic patients: standard bolus-chase and time-resolved MR angiography. Radiology 242, 610–620 (2007)PubMedCrossRef
79.
N. Diehm, A. Shang, A. Silvestro, D.D. Do, F. Dick, J. Schmidli, F. Mahler, I. Baumgartner, Association of cardiovascular risk factors with pattern of lower limb atherosclerosis in 2659 patients undergoing angioplasty. Eur. J. Vasc. Endovasc. Surg. 31(1), 59–63 (2006)PubMedCrossRef
80.
A. Ndip, L. Lavery, A.J.M. Boulton, Diabetic foot disease in people with advanced nephropathy and those on renal dialysis. Curr. Diabetes Rep. 10, 283–290 (2010)CrossRef
81.
M. Heikkinen, M. Salmenperä, A. Lepäntalo, M. Lepäntalo, Diabetes care for patients with peripheral arterial disease. Eur. J. Vasc. Endovasc. Surg. 33, 583–591 (2007)PubMedCrossRef
82.
M.R. Prince, H. Zhang, M. Morris, J.L. MacGregor, M.E. Grossman, J. Silberzweig, R.L. DeLapaz, H.J. Lee, C.M. Magro, A.M. Valeri, Incidence of nephrogenic systemic fibrosis at two large medical centers. Radiology 248(3), 807–816 (2008)PubMedCrossRef
83.
C. Rydahl, H.S. Thomsen, P. Marckmann, High prevalence of nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent. Invest. Radiol. 43(2), 141–144 (2008)PubMedCrossRef
84.
R. Wertman, E. Altun, D.R. Martin, D.G. Mitchell, J.R. Leyendecker, R.B. O’Malley, D.J. Parsons, E.R. Fuller 3rd, R.C. Semelka, Risk of nephrogenic systemic fibrosis: evaluation of gadolinium chelate contrast agents at four American universities. Radiology 248(3), 799–806 (2008)PubMedCrossRef
85.
J. Apelqvist, T. Elgzyri, J. Larsson, M. Löndahl, P. Nyberg, J. Thörne, Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients. J. Vasc. Surg. 53(6), 1582–1588 (2011)PubMedCrossRef
86.
E. Faglia, G. Clerici, J. Clerissi, L. Gabrielli, S. Losa, M. Mantero, M. Caminiti, V. Curci, A. Quarantiello, T. Lupattelli, A. Morabito, Long-term prognosis of diabetic patients with critical limb ischemia: a population-based cohort study. Diabetes Care 32(5), 822–827 (2009)PubMedCrossRef
87.
L. Uccioli, R. Gandini, L. Giurato, S. Fabiano, E. Pampana, V. Spallone, E. Vainieri, G. Simonetti, Long-term outcomes of diabetic patients with critical limb ischaemia followed in a tertiary referral diabetic foot clinic. Diabetes Care 33(5), 977–982 (2010)PubMedCrossRef
88.
Hinchliffe et al., A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes Metab. Res. Rev. 28(Suppl 1), 179–217 (2012)
89.
E. Faglia, G. Clerici, J. Clerissi, M. Mantero, M. Caminiti, A. Quarantiello et al., When is a technically successful peripheral angioplasty effective in preventing above-the-ankle amputation in diabetic patients with critical limb ischaemia? Diabet. Med. 24, 823–829 (2007)PubMedCrossRef
90.
F. Sigala, Ch. Menenakos, P. Sigalas, Ch. Baunach, S. Langer, E. Papalambros et al., Transluminal angioplasty of isolated crural arterial lesions in diabetics with critical limb ischemia. VASA 34, 186–191 (2005)PubMedCrossRef
91.
T. Zeller, S. Sixt, A. Rastan, New techniques for endovascular treatment of peripheral artery disease with focus on chronic critical limb ischemia. VASA 38, 3–12 (2009)PubMedCrossRef
92.
H.H. Dosluoglu, G.S. Cherr, P. Lall, L.M. Harris, M.L. Dryjski, Peroneal artery-only runoff following endovascular revascularizations is effective for limb salvage in patients with tissue loss. J. Vasc. Surg. 48, 137–143 (2008)PubMedCrossRef
93.
E. Faglia, L. Dalla Paola, G. Clerici, J. Clerissi, L. Graziani, M. Fusaro, L. Gabrielli, S. Losa, A. Stella, M. Gargiulo, M. Mantero, M. Caminiti, S. Ninkovic, V. Curci, A. Morabito, Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur. J. Vasc. Endovasc. Surg. 29(6), 620–627 (2005)PubMedCrossRef
94.
L. Graziani, A. Piaggesi, Indications and clinical outcomes for below knee endovascular therapy: review article. Catheter. Cardiovasc. Interv. 75(3), 433–443 (2010)PubMed
95.
M. Manzi, M. Fusaro, T. Ceccacci, G. Erente, L. Dalla Paola, E. Brocco, Clinical results of below-the knee intervention using pedal-plantar loop technique for the revascularization of foot arteries. J. Cardiovasc. Surg. 50(3), 331–337 (2009)
96.
D.M. Ihnat, J.L. Mills Sr, Current assessment of endovascular therapy for infrainguinal arterial occlusive disease in patients with diabetes. J. Vasc. Surg. 52(Suppl 3), 92S–95S (2010)PubMedCrossRef
97.
V.A. Alexandrescu, G. Hubermont, Y. Philips, B. Guillaumie, C. Ngongang, P. Vandenbossche, K. Azdad, G. Ledent, J. Horion, Selective primary angioplasty following an angiosome model of reperfusion in the treatment of Wagner 1–4 diabetic foot lesions: practice in a multidisciplinary diabetic limb service. J. Endovasc. Ther. 15(5), 580–593 (2008)PubMedCrossRef
98.
C. Setacci, G. De Donato, F. Setacci, E. Chisci, Ischemic foot: definition, etiology and angiosome concept. J. Cardiovasc. Surg. 51(2), 223–231 (2010)
99.
R.F. Neville, C.E. Attinger, E.J. Bulan, I. Ducic, M. Thomassen, A.N. Sidawy, Revascularization of a specific angiosome for limb salvage: does the target artery matter? Ann. Vasc. Surg. 23(3), 367–373 (2009)PubMedCrossRef
100.
C.E. Attinger, K.K. Evans, E. Bulan, P. Blume, P. Cooper, Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast. Reconstr. Surg. 117(7 Suppl), 261S–293S (2006)PubMedCrossRef
101.
M.I. Söderström, E.M. Arvela, M. Korhonen, K.H. Halmesmäki, A.N. Albäck, F. Biancari, M.J. Lepäntalo, M.A. Venermo, Infrapopliteal percutaneous transluminal angioplasty versus bypass surgery as first-line strategies in critical leg ischemia: a propensity score analysis. Ann. Surg. 252(5), 765–773 (2010)PubMedCrossRef
102.
R. Met, K.P. Van Lienden, M.J. Koelemay, S. Bipat, D.A. Legemate, J.A. Reekers, Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review. Cardiovasc. Interv. Radiol. 31, 687–697 (2008)CrossRef
103.
F.B. Pomposelli, N. Kansal, A.D. Hamdan, A. Belfield, M. Sheahan, D.R. Campbell, J.J. Skillman, F.W. Logerfo, A decade of experience with dorsalis pedis artery bypass: analysis of outcome in more than 1000 cases. J. Vasc. Surg. 37, 307–315 (2003)PubMedCrossRef
104.
M. Kalani, J. Apelqvist, M. Blombäck, K. Brismar, B. Eliasson, J.W. Eriksson et al., Effect of dalteparin on the healing of chronic foot ulcers in diabetic patients with peripheral arterial occlusive disease: a prospective, randomized, double-blind, placebo-controlled study. Diabetes Care 26(9), 2575–2580 (2003)PubMedCrossRef
105.
M. Rullan, L. Cerda, G. Frontera, L. Masmiquel, J. Llobera, Treatment oc chronic diabetic foot ulcers with bemiparin a randomized, triple-blind, placebo controlled, clinical trial. Diabet. Med. 25(9), 1090–1095 (2008). Erratum in: Diabet. Med. 25(10), 1257 (2008)
106.
M. Weck, H. Rietzsch, H. Lawall, U. Pichlmeier, P. Bramlage, S. Schellong, Intermittent intravenous urokinase for critical limb ischemia in diabetic foot ulceration. Thromb. Haemost. 100(3), 475–482 (2008)PubMed
107.
R.J. Hinchliffe, G.D. Valk, J. Apelqvist, D.G. Armstrong, K. Bakker, F.L. Game et al., A systematic review of the effectiveness of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab. Res. Rev. 24(Suppl 1), S119–S144 (2008)PubMedCrossRef
108.
Game et al., A systematic review of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab. Res. Rev. 28(Suppl 1), 119–141 (2012)
109.
M. Eneroth, J. Larsson, J. Apelqvist, Foot infections in diabetes mellitus—entity with different characteristics, treatment and prognosis. J. Diabetes Complicat. 13(5–6), 254–263 (1999)PubMedCrossRef
110.
M. Eneroth, J. Apelqvist, Clinical characteristics and outcome in diabetic patients with deep foot infections. Foot Ankle 18, 716–722 (1997)PubMed
111.
B.A. Lipsky, A.R. Berendt, J. Embil, F. de Lalla, Diagnosing and treating diabetic foot infections. Diabetes Metab. Res. Rev. 20(Suppl 1), S56–S64 (2004)PubMedCrossRef
112.
L.A. Lavery, D. Armstrong, R. Wunderlich, M. Mohler, C. Wendel, B. Lipsky, Risk factors for foot infections in individuals with diabetes. Diabetes Care 29, 1288–1293 (2006)PubMedCrossRef
113.
B.A. Lipsky, Y.P. Tabak, R.S. Johannes et al., Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost. Diabetologia 53, 914–923 (2010)PubMedCrossRef
114.
A.R. Berendt, E.J. Peters, K. Bakker, J.M. Embil, M. Eneroth, R.J. Hinchliffe, W.J. Jeffcoate, B.A. Lipsky, E. Senneville, J. Teh, G.D. Valk, Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment. Diabetes Metab. Res. Rev. 24(Suppl 1), S145–S161 (2008)PubMedCrossRef
115.
S. Butalia, V.A. Palda, R.J. Sargeant, A.S. Detsky, O. Mourad, Does this patient with diabetes have osteomyelitis of the lower extremity? JAMA 299, 806–813 (2008)PubMedCrossRef
116.
117.
G. Pellizer, M. Strazzabosco et al., Deep tissue biopsy vs superficial swap culture monitoring in the microbiological assessment of limb-threatening diabetic foot infection. Diabet. Med. 18, 822–827 (2001)CrossRef
118.
D.R. Graham, C. Lucasti, O. Malafaia, R.L. Nichols, P. Holtom, N.Q. Perez, A. McAdams, G.L. Woods, T.P. Ceesay, R. Gesser, Ertapenem once daily versus piperacillin-tazobactam 4 times per day for treatment of complicated skin and skin-structure infections in adults: results of a prospective, randomized, double-blind multicenter study. Clin. Infect. Dis. 34(11), 1460–1468 (2002)PubMedCrossRef
119.
N. Saltoglu, A. Dalkiran, T. Tetiker, H. Bayram, Y. Tasova, C. Dalay, M. Sert, Piperacillin/tazobactam versus imipenem/cilastatin for severe diabetic foot infections: a prospective, randomized clinical trial in a university hospital. Clin. Microbiol. Infect. 16(8), 1252–1257 (2010)PubMedCrossRef
120.
D.R. Graham, D.A. Talan, R.L. Nichols, C. Lucasti, M. Corrado, N. Morgan, C.L. Fowler, Once-daily, high-dose levofloxacin versus ticarcillin-clavulanate alone or followed by amoxicillin-clavulanate for complicated skin and skin-structure infections: a randomized, open-label trial. Clin. Infect. Dis. 35(4), 381–389 (2002)PubMedCrossRef
121.
B.A. Lipsky, K.J. Holroyd, M. Zasloff, Topical versus systemic antimicrobial therapy for treating mildly infected diabetic foot ulcers: a randomized, controlled, double-blinded, multicenter trial of pexiganan cream. Clin. Infect. Dis. 47(12), 1537–1545 (2008)PubMedCrossRef
122.
J.S. Tan, N.M. Friedman, C. Hazelton-Miller, J.P. Flanagan, T.M. File Jr, Can aggressive treatment of diabetic foot infections reduce the need for above-ankle amputation? Clin. Infect. Dis. 23(2), 286–291 (1996)PubMedCrossRef
123.
A.D. Tice, R.S. Turpin, C.T. Hoey, B.A. Lipsky, J. Wu, M.A. Abramson, Comparative costs of ertapenem and piperacillin-tazobactam in the treatment of diabetic foot infections. Am. J. Health Syst. Pharm. 64(10), 1080–1086 (2007)PubMed
124.
B.A. Lipsky, D.G. Armstrong, D.M. Citron, A.D. Tice, D.E. Morgenstern, M.A. Abramson, Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial. Lancet 366(9498), 1695–1703 (2005)PubMedCrossRef
125.
P.G. Clay, M.R. Graham, C.C. Lindsey, K.C. Lamp, C. Freeman, A. Glaros, Clinical efficacy, tolerability, and cost savings associated with the use of open-label metronidazole plus ceftriaxone once daily compared with ticarcillin/clavulanate every 6 hours as empiric treatment for diabetic lower-extremity infections in older males. Am. J. Geriatr. Pharmacother. 2(3), 181–189 (2004)PubMedCrossRef
126.
R. Lobmann, A. Ambrosch, M. Seewald, M. Dietlein, K. Zink, K.H. Kullmann, H. Lehnert, Antibiotic therapy for diabetic foot infections: comparison of cephalosporines with chinolones. Diabetes Nutr. Metab. 17(3), 156–162 (2004)PubMed
127.
R.W. Bradsher Jr, R.M. Snow, Ceftriaxone treatment of skin and soft tissue infections in a once daily regimen. Am. J. Med. 77(4), 63–67 (1984)PubMed
128.
B.A. Lipsky, U. Stoutenburgh, Daptomycin for treating infected diabetic foot ulcers: evidence from a randomized, controlled trial comparing daptomycin with vancomycin or semi-synthetic penicillins for complicated skin and skin-structure infections. J. Antimicrob. Chemother. 55(2), 240–245 (2005)PubMedCrossRef
129.
G. Siami, N. Christou, I. Eiseman, K.J. Tack, Clinafloxacin versus piperacillintazobactam in treatment of patients with severe skin and soft tissue infections. Antimicrob. Agents Chemother. 45(2), 525–531 (2001)PubMedCrossRef
130.
L. Harkless, J. Boghossian, R. Pollak, W. Caputo, A. Dana, S. Gray, D. Wu, An open-label, randomized study comparing efficacy and safety of intravenous piperacillin/tazobactam and ampicillin/sulbactam for infected diabetic foot ulcers. Surg. Infect. (Larchmt.) 6(1), 27–40 (2005)CrossRef
131.
G.J. Noel, K. Bush, P. Bagchi, J. Ianus, R.S. Strauss, A randomized, double-blind trial comparing ceftobiprole medocaril with vancomycin plus ceftazidime for the treatment of patients with complicated skin and skin-structure infections. Clin. Infect. Dis. 46(5), 647–655 (2008)PubMedCrossRef
132.
R. Vick-Fragoso, G. Hernández-Oliva, J. Cruz-Alcázar, C.F. Amábile-Cuevas, P. Arvis, P. Reimnitz, J.R. Bogner, STIC Study Group, Efficacy and safety of sequential intravenous/oral moxifloxacin vs intravenous/oral amoxicillin/clavulanate for complicated skin and skin structure infections. Infection 37(5), 407–417 (2009)PubMedCrossRef
133.
B.L. Erstad, J. McIntyre, Prospective, randomized comparison of ampicillin/sulbactam and cefoxitin for diabetic foot infections. Vasc. Surg. 31(4), 419–426 (1997)
134.
B.A. Lipsky, P.D. Baker, G.C. Landon, R. Fernau, Antibiotic therapy for diabetic foot infections: comparison of two parenteral-to-oral regimens. Clin. Infect. Dis. 24(4), 643–648 (1997)PubMedCrossRef
135.
B.A. Lipsky, K. Itani, C. Norden, Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillinsulbactam/amoxicillin-clavulanate. Clin. Infect. Dis. 38(1), 17–24 (2004)PubMedCrossRef
136.
B.A. Lipsky, P. Giordano, S. Choudhri, J. Song, Treating diabetic foot infections with sequential intravenous to oral moxifloxacin compared with piperacillintazobactam/amoxicillin-clavulanate. J. Antimicrob. Chemother. 60(2), 370–376 (2007)PubMedCrossRef
137.
M.L. Grayson, G.W. Gibbons, G.M. Habershaw, D.V. Freeman, F.B. Pomposelli, B.I. Rosenblum, E. Levin, A.W. Karchmer, Use of ampicillin/sulbactam versus imipenem/cilastatin in the treatment of limb-threatening foot infections in diabetic patients. Clin. Infect. Dis. 18(5), 683–693 (1994)PubMedCrossRef
138.
139.
A. Yönem, B. Cakir, S. Guler, O.O. Azal, A. Corakci, Effects of granulocyte-colony stimulating factor in the treatment of diabetic foot infection. Diabetes Obes. Metab. 3(5), 332–337 (2001)PubMedCrossRef
140.
F. de Lalla, G. Pellizzer, M. Strazzabosco, Z. Martini, J.G. Du, L. Lora, P. Fabris, P. Benedetti, G. Erle, Randomized prospective controlled trial of recombinant granulocyte colony-stimulating factor as adjunctive therapy for limbthreatening diabetic foot infection. Antimicrob. Agents Chemother. 45(4), 1094–1098 (2001)PubMedCrossRef
141.
T. Kästenbauer, B. Hornlein, G. Sokol, K. Irsigler, Evaluation of granulocytecolony stimulating factor (Filgrastim) in infected diabetic foot ulcers. Diabetologia 46(1), 27–30 (2003)PubMed
142.
A. Gough, M. Clapperton, N. Rolando, A.V. Foster, J. Philpott-Howard, M.E. Edmonds, Randomised placebo-controlled trial of granulocyte-colony stimulating factor in diabetic foot infection. Lancet 350(9081), 855–859 (1997)PubMedCrossRef
143.
M. Cruciani, B.A. Lipsky, C. Mengoli, F. de Lalla, Granulocyte-colony stimulating factors as adjunctive therapy for diabetic foot infections. Cochrane Database Syst. Rev. 8(3), CD006810 (2009)
144.
E. Faglia, G. Clerici, M. Caminiti, A. Quarantiello, M. Gino, A. Morabito, The role of early surgical debridement and revascularization in patients with diabetes and deep foot space abscess: retrospective review of 106 patients with diabetes. J. Foot Ankle Surg. 45(4), 220–226 (2006)PubMedCrossRef
145.
E. Senneville, A. Lombart, E. Beltrand, M. Valette, L. Legout, M. Cazaubiel, Y. Yazdanpanah, P. Fontaine, Outcome of diabetic foot osteomyelitis treated nonsurgically: a retrospective cohort study. Diabetes Care 31(4), 637–642 (2008)PubMedCrossRef
146.
K.Z. Vardakas, M. Horianopoulou, M.E. Falagas, Factors associated with treatment failure in patients diabetic foot infections: an analysis of data from randomised controlled trials. Diabetes Res. Clin. Pract. 80, 344–351 (2008)PubMedCrossRef
147.
M.G. Sheahan, A.D. Hamdan, J.R. Veraldi, C.S. McArthur, J.J. Skillman, D.R. Campbell et al., Lower extremity minor amputations: the roles of diabetes mellitus and timing of revascularization. J. Vasc. Surg. 42, 476–480 (2005)PubMedCrossRef
148.
P.A. Stone, M.R. Back, P.A. Armstrong, S.K. Flaherty, W.B. Keeling, B.L. Johnson, M.L. Shames, D.F. Bandyk, Midfoot amputations expand limb salvage rates for diabetic foot infections. Ann. Vasc. Surg. 19(6), 805–811 (2005)PubMedCrossRef
149.
W.J. Jeffcoate, S.Y. Chipchase, P. Ince, F.L. Game, Assessing the outcome of the management of diabetic foot ulcers using ulcer-related and person-related measures. Diabetes Care 29, 1784–1787 (2006)PubMedCrossRef
150.
M.J. Young, J.E. McCardle, L.E. Randall, J.I. Barclay, Improved survival of diabetic foot ulcer patients 1995–2008: possible impact of aggressive cardiovascular risk management. Diabetes Care 31, 2143–2147 (2008)PubMedCrossRef
151.
152.
F. Game, The advantages and disadvantages of non-surgical management of the diabetic foot. Diabetes Metab. Res. Rev. 24(Suppl 1), S72–S75 (2008)PubMedCrossRef
153.
R. Sibbald, K. Woo, The biology of chronic foot ulcers in persons with diabetes. Diabetes Metab. Res. Rev. 24(Suppl 1), S25–S30 (2008)CrossRef
154.
S.M. Bergin, P. Wraight, Silver based wound dressings and topical agents for treating diabetic foot ulcers. Cochrane Database Syst. Rev. (1), CD005082 (2006)
155.
D.G. Armstrong, Diabetic Foot Study Consortium, Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 366, 1704–1710 (2005)PubMedCrossRef
156.
M.T. Eginton, K.R. Brown, G.R. Seabrook, J.B. Towne, R.A. Cambria, A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds. Ann. Vasc. Surg. 17, 645–649 (2003)PubMedCrossRef
157.
A. Etöz, Y. Özgenel, M. Özcan, The use of negative pressure wound therapy on diabetic foot ulcers: a preliminary controlled trial. Wounds 16, 264–269 (2004)
158.
S.K. McCallon, C.A. Knight, J.P. Valiulus, M.W. Cunningham, J.M. McCulloch, L.P. Farinas, Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manage. 46, 28–34 (2000)PubMed
159.
P.A. Blume, J. Walters, W. Payne, J. Ayala, J. Lantis, Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers. Diabetes Care 31, 631–636 (2008)PubMedCrossRef
160.
P. Vikatmaa, V. Juutilainen, P. Kuukasjärvi, A. Malmivaara, Negative pressure wound therapy: a systematic review on effectiveness and safety. Eur. J. Vasc. Endovasc. Surg. 36, 438–448 (2008)PubMedCrossRef
161.
E. Faglia, F. Favales, A. Aldeghi, P. Calia, A. Quarantiello, G. Oriani et al., Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer. A randomized study. Diabetes Care 19, 1338–1343 (1996)PubMedCrossRef
162.
A. Abidia, G. Laden, G. Kuhan, B.F. Johnson, A.R. Wilkinson, P.M. Renwick et al., The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial. Eur. J. Vasc. Endovasc. Surg. 25, 513–518 (2003)PubMedCrossRef
163.
N. Doctor, S. Pandya, A. Supe, Hyperbaric oxygen therapy in diabetic foot. J. Postgrad. Med. 38, 112–114 (1992)PubMed
164.
G. Baroni, T. Porro, E. Faglia, G. Pizzi, A. Mastropasqua, G. Oriani et al., Hyperbaric oxygen in diabetic gangrene treatment. Diabetes Care 10, 81–86 (1987)PubMedCrossRef
165.
W.A. Zamboni, H.P. Wong, L.L. Stephenson, M.A. Pfeifer, Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study. Undersea Hyperb. Med. 24, 175–179 (1997)PubMed
166.
M. Kalani, G. Jörneskog, N. Naderi, F. Lind, K. Brismar, Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up. J. Diabetes Complicat. 16, 153–158 (2002)PubMedCrossRef
167.
M. Löndahl, P. Katzman, A. Nilsson, C. Hammarlund, Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care 33, 998–1003 (2010)PubMedCrossRef
168.
T. Tan, E.J. Shaw, F. Siddiqui, P. Kandaswamy, P.W. Barry, Guideline Development Group, Inpatient management of diabetic foot problems: summary of NICE guidance. BMJ 342, 702–703 (2011)CrossRef
169.
R. van Deursen, Footwear for the neuropathic patient: offloading and stability. Diabetes Metab. Res. Rev. 24(Suppl 1), S96–S100 (2008)PubMedCrossRef
170.
S.A. Bus, G.D. Valk, R.W. van Deursen, D.G. Armstrong, C. Caravaggi, P. Hlavácek et al., The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab. Res. Rev. 24(Suppl 1), S162–S180 (2008)PubMedCrossRef
171.
P.R. Cavanagh, S.A. Bus, Off-loading the diabetic foot for ulcer prevention and healing. J. Vasc. Surg. 52(3 Suppl), 37S–43S (2010)PubMedCrossRef
172.
T.M. Owings, J. Apelqvist, A. Stenström, M. Becker, S. Bus, A. Kalpen, J.S. Ulbrecht, P. Cavanagh, Plantar pressures in diabetic foot ulcer patients who have remained healed. Diabet. Med. 26(11), 1141–1146 (2009)PubMedCrossRef
173.
I.A. Katz, A. Harlan, B. Miranda-Palma, L. Prieto-Sanchez, D.G. Armstrong, J.H. Bowker et al., A randomized trial of two irremovable off-loading devices in the management of plantar neuropathic diabetic foot ulcers. Diabetes Care 28, 555–559 (2005)PubMedCrossRef
174.
D.G. Armstrong, L.A. Lavery, S. Wu, A.J. Boulton, Evaluation of removable and irremovable cast walkers in the healing of diabetic foot wounds: a randomized controlled trial. Diabetes Care 28, 551–554 (2005)PubMedCrossRef
175.
P.A. Blume, L.K. Paragas, B.E. Sumpio, C.E. Attinger, Single-stage surgical treatment of noninfected diabetic foot ulcers. Plast. Reconstr. Surg. 109, 601–609 (2002)PubMedCrossRef
176.
C.E. Attinger, I. Ducic, P. Cooper, C.M. Zelen, The role of intrinsic muscle flaps of the foot for bone coverage in foot and ankle defects in diabetic and nondiabetic patients. Plast. Reconstr. Surg. 110, 1047–1054 (2002)PubMedCrossRef
177.
A. Piaggesi, E. Schipani, F. Campi, M. Romanelli, F. Baccetti, C. Arvia et al., Conservative surgical approach versus non-surgical management for diabetic neuropathic foot ulcers: a randomized trial. Diabet. Med. 15, 412–417 (1998)PubMedCrossRef
178.
E.J. Fitzgerald O’Connor, M. Vesely, P.J. Holt, K.G. Jones, M.M. Thompson, R.J. Hinchliffe, A systematic review of free tissue transfer in the management of non-traumatic lower extremity wounds in patients with diabetes. Eur. J. Vasc. Endovasc. Surg. 41(3), 391–399 (2011)PubMedCrossRef
179.
E. Tukiainen, M. Kallio, M. Lepantalo, Advanced leg salvage of the critically ischemic leg with major tissue loss by vascular and plastic surgeon teamwork: long-term outcome. Ann. Surg. 244, 949–957 (2006)PubMedCrossRef
180.
C. Randon, F. Vermassen, B. Jacobs, F. De Ryck, K. Van Landuyt, Y. Taes, Outcome of arterial reconstruction and free-flap coverage in diabetic foot ulcers: long-term results. World J. Surg. 34(1), 177–184 (2010)PubMedCrossRef
181.
M.J. Mueller, D.R. Sinacore, M.K. Hastings, M.J. Strube, J.E. Johnson, Effect of Achilles tendon lengthening on neuropatic plantar ulcers. A randomized clinical trial. J. Bone Joint Surg. Am. 85A, 1436–1445 (2003)
182.
N.L. Petrova, M.E. Edmonds, Charcot neuro-osteoarthropathy—current standards. Diabetes Metab. Res. Rev. 24(Suppl 1), S58–S61 (2008)PubMedCrossRef
183.
H. Svensson, J. Larsson, J. Apelqvist, M. Eneroth, Minor amputations successful in patients with diabetes mellitus and severe foot ulcers threatening the survival of the foot. J. Wound Care 20, 261-2, 264, 266 (2011)
184.
V. Dargis, O. Pantelejeva, A. Jonushaite, A. Boulton, I. Vileikyte, Benefits of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania: a prospective study. Diabetes Care 22(9), 1428–1431 (1999)PubMedCrossRef
185.
C.J. McCabe, R.C. Stevenson, A.M. Dolan, Evaluation of diabetic foot screening and protection programme. Diabetes Med. 15, 80–84 (1998)CrossRef
186.
J. Larsson, C.D. Agardh, J. Apelqvist, A. Stenström, Long term prognosis after amputation in diabetic patients. Clin. Orthop. Relat. Res. 350, 149–158 (1998)PubMedCrossRef
Metadata
Title
Diagnostics and treatment of the diabetic foot
Author
Jan Apelqvist
Publication date
01-06-2012
Publisher
Springer US
Published in
Endocrine / Issue 3/2012
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-012-9619-x

Other articles of this Issue 3/2012

Endocrine 3/2012 Go to the issue

Original Article

Association between E-cadherin (CDH1) polymorphisms and papillary thyroid carcinoma risk in Han Chinese population

Original Article

The impact of birth weight and maternal history on acne, hirsutism, and menstrual disorder symptoms in Turkish adolescent girls

Original Article

Does Apolipoprotein E genotype affect cardiovascular risk in subjects with acromegaly?

Original Article

Reproducibility and performance of one or two samples of salivary cortisol in the diagnosis of Cushing’s syndrome using an automated immunoassay system

Original Article

Serum sphingolipids and inflammatory mediators in adolescents at risk for metabolic syndrome

Original Article

TGF-β and IL-23 gene expression in unstimulated PBMCs of patients with diabetes
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits