Diabetic foot ulcer
ICD-10 E11.6; E10.6 · ICD-11 BD54

Diabetic Foot Ulcer with Low Ankle-Brachial Index (ABI <0.5) or Markedly Reduced Ankle Pressure

This page covers management of diabetic foot ulcer when objective perfusion measurements indicate markedly reduced blood flow to the foot.

Clinical situation

This protocol applies when one or more of the following perfusion thresholds is met:

Treatment approach

The protocol calls for urgent vascular imaging and, where findings support it, revascularisation.

Clinical goals

Restoration of direct blood flow to at least one of the foot arteries, confirmed by an objective measurement of perfusion.

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References

  1. In patients with either an ankle pressure <50mm Hg or an ABI <0.5 consider urgent vascular imaging and, when findings suggest it is appropriate, revascularisation.
  2. Also consider revascularisation if the toe pressure is <30mmHg or TcpO2 is <25 mmHg.
  3. The aim of revascularisation is to restore direct flow to at least one of the foot arteries, preferably the artery that supplies the anatomical region of the wound.
  4. After a revascularisation procedure, its effectiveness should be evaluated with an objective measurement of perfusion.
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