Table 4.
Treatment
|
Description
|
|
Debridement | Surgical debridement | Necrotic or non-viable tissue should be removed, regular (weekly) debridement is associated with rapid healing of ulcers |
Dressing | Films, foams, hydrocolloids, hydrogel | Proper using of dressing materials could facilitate moist environment |
Wound off-loading | Rock or bottom outsoles, custom-made insoles, some shoe inserts | Plantar shear stress should be removed |
Vascular assessment | PTA or endovascular recanalization followed by PTA or by-pass grafting | Arterial insufficiency should be treated for improving wound healing |
Control of infection | Appropriate antibiotic therapy according to pathogens | Deep tissue cultures should be obtained before antibiotic therapy, for mild infection treatment duration could be 1-2 wk but for moderate to severe infection, it should be 3-4 wk |
Glycemic control | For better glycemic control, insulin treatment has been preferred in hospitalized patients with diabetic foot ulcers |
PTA: Percutaneous transluminal angioplasty.