علاج قرحة القدم السكرية: إدارة مستندة إلى الأدلة في الخط الأول

References

• The preferred offloading treatment for a neuropathic plantar ulcer is a non-removable knee-high offloading device, i.e., either a total contact cast (TCC) or removable walker rendered (by the provider fitting it) irremovable.
• Debride the ulcer and remove surrounding callus (preferably with sharp surgical instruments), and repeat as needed.
• Select dressings to control excess exudation and maintain moist environment.
• Optimise glycaemic control, if necessary with insulin.
• Treat oedema or malnutrition, if present.
• When an ulcer fails to show signs of healing within 6 weeks, despite optimal management, consider revascularisation, irrespective of the results of the vascular diagnostic tests described above.