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. 2015 Sep 1;4(9):545–559. doi: 10.1089/wound.2015.0634

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Copyright 2015, Mary Ann Liebert, Inc.

© Jonathan N. Brantley and Thomas D. Verla 2015; Published by Mary Ann Liebert, Inc.

This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

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Figure 1. — Treatment algorithm for the assessment of high-risk DFU patients. This algorithm was developed and implemented at the Hunter Holmes McGuire VA Medical Center. The algorithm is based on our current understanding of key factors that can impair wound healing. All patients with high-risk DFUs, which are characterized by neuropathy and microangiopathy, undergo screening before selection of wound treatment modalities. The purpose of this algorithm is for the standardization of wound treatment and the improvement of clinical outcomes. ABI, ankle-brachial index; ABG, arterial blood gases; APSV, ankle peak systolic velocity; BMP, basic metabolic panel; C&S Punch Biopsy, culture and sensitivity punch biopsy; CBC w Diff., complete blood count with differential; CRP, C-reactive protein; DFU, diabetic foot ulcer; ECM, extracellular matrix; HgA1C, hemoglobin A1C; IR, interventional radiology; LR, lactated ringers; MRI, magnetic resonance imaging; OM, osteomyelitis; ORC, oxidized regenerated cellulose; PDGF-BB, platelet-derived growth factor-BB; Phase ID, phase identification; PRFE, pulsed radio frequency energy; PTH, parathyroid hormone; TBI, toe-brachial index; TCC, total contact cast.