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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 10, 2016; 7(7): 153-164
Published online Apr 10, 2016. doi: 10.4239/wjd.v7.i7.153
Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities
Noha Amin, John Doupis
Noha Amin, Department of Internal Medicine (Diabetes and Metabolism Unit), Alexandria University, Alexandria 21526, Egypt
John Doupis, Iatriko Paleou Falirou Medical Center, Division of Diabetes and Clinical Research Center, 17562 Athens, Greece
John Doupis, Postgraduate Diabetes Education, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, CF14 4XN, United Kingdom
Author contributions: This paper is a part of Amin Noha’s MSc Dissertation in Postgraduate Diabetes Education, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine; the MSc dissertation was supervised by Dr. John Doupis.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: John Doupis, MD, PhD, Iatriko Paleou Falirou Medical Center, Division of Diabetes and Clinical Research Center, 36 Areos st, Paleo Faliro, 17562 Athens, Greece. john.doupis@joslin.harvard.edu
Telephone: +30-210-9892300 Fax: +30-210-9892300
Received: August 27, 2015
Peer-review started: August 30, 2015
First decision: September 28, 2015
Revised: November 2, 2015
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: April 10, 2016
Processing time: 223 Days and 12.9 Hours
Abstract

The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities.

Keywords: Diabetes; Diabetic foot; Diabetic ulcer; Diabetic complications; Diabetic neuropathy; Diabetic macroanggiopathy

Core tip: Foot at risk evaluation is crucial to diabetic foot ulceration prevention. Diabetic foot ulcer treatment includes standard wound care procedures, as well as, other novel treatment modalities always as add on therapy.