International Scholarly Research Notices / 2013 / Article / Tab 1 / Review Article
Wound Bed Preparation for Chronic Diabetic Foot Ulcers Table 1 Local factors and the management.
Local factors Effect Aim Management Peripheral neuropathy (1) Loss of pain sensation—prone to trauma (1) Prevent progression of peripheral neuropathy (1) Glucose control (2) Loss of intrinsic foot balance leading to hyperflexion of MTPJ and hyperflexion of IPJ—uneven pressure distribution (2) Foot hygiene and prevention of trauma (2) Appropriate footwear and podiatric advice (3) Charcot joint (3) Prevention of callus formation (3) Moisturizing (4) Autonomic neuropathy—lack of sweating, dry skin, and fissuring (4) Keeping skin soft and moist (4) Dietary supplement Peripheral vascular disease (ABI or TBI < 0.8) Poor foot perfusion Restoration/optimization of tissue perfusion Referral to vascular surgeon—angiogram, angioplasty, stenting, or bypass if possible Inappropriate footwear—with heel, narrowed/cramped toes area (1) Uneven pressure distribution—callosity, pressure ulceration (2) Trauma Eliminate risk/pressure Wear soft, fully covered shoes or sandals with back strapping, flat sole The presence of an ulcer or wound may require a special prescription shoe Treatment/removal of callus—alleviate pressure, aids advancing epithelium