What is the management of diabetic foot ulcers?
Management of diabetic foot ulcers is primarily aimed at preventing them. Strategies include: • Optimise diabetes control to reduce neuropathic and vascular complications • Stop smoking if relevant. • Preventive skin and nail care: examine the skin of both feet carefully and trim toenails regularly. See your doctor for advice if you have any skin problems such as athlete’s foot, cracks or dermatitis. • Comfortable footwear: properly fitting soft shoes or made-to-measure insoles Once ulcers have developed, the cause should be determined. Is it neuropathic, vascular or both? Neuropathic ulcers must be protected from further injury until they heal, and strenuous efforts must be made to avoid another ulcer by wearing correct footwear and frequent skin examination. Vascular or ischaemic ulcers should be evaluated by a vascular surgeon to determine the extent of damage and whether surgery is necessary; in severe cases this may entail partial amputation of the limb. Whatever the cause of the