Review
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World J Diabetes. Aug 15, 2014; 5(4): 546-556
Published online Aug 15, 2014. doi: 10.4239/wjd.v5.i4.546
Choice of wound care in diabetic foot ulcer: A practical approach
Karakkattu Vijayan Kavitha, Shalbha Tiwari, Vedavati Bharat Purandare, Sudam Khedkar, Shilpa Sameer Bhosale, Ambika Gopalakrishnan Unnikrishnan
Karakkattu Vijayan Kavitha, Podiatry Department, Chellaram Diabetes Institute, Pune 411021, India
Shalbha Tiwari, Research Department, Chellaram Diabetes Institute, Pune 411021, India
Vedavati Bharat Purandare, Sudam Khedkar, Shilpa Sameer Bhosale, Ambika Gopalakrishnan Unnikrishnan, Diabetes and Endocrinology Department, Chellaram Diabetes Institute, Pune 411021, India
Author contributions: Unnikrishnan AG and Kavitha KV contributed to the idea behind the manuscript and to the writing, modification of content, and final approval of the draft; Tiwari S contributed to writing of the manuscript, its modification, and final approval; Purandare VB, Khedkar S and Bhosale SS contributed to writing of the manuscript and its final approval.
Correspondence to: Dr. Ambika Gopalakrishnan Unnikrishnan, Chief Endocrinologist, Diabetes and Endocrinology Department, Chellaram Diabetes Institute, 1st Floor, Lalani Quantum, Bavdhan, Pune 411021, India. unnikrishnanag@gmail.com
Telephone: +91-20-66839717 Fax: +91-20-66839701
Received: November 11, 2013
Revised: May 23, 2014
Accepted: May 29, 2014
Published online: August 15, 2014
Processing time: 269 Days and 22.6 Hours
Abstract

Diabetic foot ulcers are the consequence of multiple factors including peripheral neuropathy, decreased blood supply, high plantar pressures, etc., and pose a significant risk for morbidity, limb loss and mortality. The critical aspects of the wound healing mechanism and host physiological status in patients with diabetes necessitate the selection of an appropriate treatment strategy based on the complexity and type of wound. In addition to systemic antibiotics and surgical intervention, wound care is considered to be an important component of diabetic foot ulcer management. This article will focus on the use of different wound care materials in diabetic foot. From a clinical perspective, it is important to decide on the wound care material depending on the type and grade of the ulcer. This article will also provide clinicians with a simple approach to the choice of wound care materials in diabetic foot ulcer.

Keywords: Diabetes; Foot; Wound; Debridement; Topical

Core tip: Diabetic foot ulcers are an important complication of diabetes. There is no conventional guideline regarding the selection of wound care materials in diabetic foot wounds. This article includes fundamental aspects of wound care and management with special emphasis on the selection of appropriate wound care materials depending on the type of wound tissue. Risk factors for foot ulceration, classification and grading of wounds, bacteriology, multidisciplinary team approach, types of debridement, importance of offloading, wound care and choice based on the complexity of the wound and properties of the dressing regime in each category based on clinical experience and practice are discussed.