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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2015; 6(1): 37-53
Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.37
Literature review on the management of diabetic foot ulcer
Leila Yazdanpanah, Morteza Nasiri, Sara Adarvishi
Leila Yazdanpanah, Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran
Morteza Nasiri, Sara Adarvishi, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 7541886547, Iran
Author contributions: Yazdanpanah L, Nasiri M and Adarvishi S contributed equally to this work and performed the literature search and wrote first draft; Yazdanpanah L provided expert opinion and reviewed the paper.
Supported by Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Conflict-of-interest: The authors declared no conflict-of-interest.
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: Morteza Nasiri, BSc, MSc, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan road, Khozestan, Ahvaz 7541886547, Iran. mortezanasiri.or87@yahoo.com
Telephone: +98-772-6225292 Fax: +98-772-6223012
Received: July 3, 2014
Peer-review started: July 3, 2014
First decision: July 29, 2014
Revised: November 18, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: February 15, 2015
Abstract

Diabetic foot ulcer (DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime. Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it’s suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.

Keywords: Diabetes mellitus, Wound management, Diabetic foot ulcer, Amputation, Foot care

Core tip: Diabetic foot ulcer (DFU) is the most common complication of diabetes mellitus that usually fail to heal, and leading to lower limb amputation. Early effective management of DFU as follows: education, blood sugar control, wound debridement, advanced dressing, offloading, advance therapies and in some cases surgery, can reduce the severity of complications, and also can improve overall quality of life of patients especially by using a multidisciplinary team approach.