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Diabetic Foot Wound Care Algorithms

Paul Han, MS, DPM^* and Ruben Ezquerro, DPM

^* Diplomate, American Board of Podiatric Surgery; Medical Director, Diabetic Foot Care Center, Coastal Communities Hospital, Tenet Health System, Santa Ana, CA.
Staff Podiatric Physician, Diabetic Foot Care Center, Coastal Communities Hospital, Tenet Health System, Santa Ana, CA.

Mailing address: 2621 S Bristol St, Ste 209, Santa Ana, CA 92704.

Abstract

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)