Armstrong DG, Lavery LA, Nixon BP, Boulton AJ, et al.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of Am.... Date of publication 2004 Aug 1;volume 39 Suppl 2():S92-9.
1. Clin Infect Dis. 2004 Aug 1;39 Suppl 2:S92-9.
It's not what you put on, but what you take off: techniques for debriding and
off-loading the diabetic foot wound.
Armstrong DG(1), Lavery LA, Nixon BP, Boulton AJ.
Author information:
(1)Department of Surgery, Dr. William M. Scholl College of Podiatric Medicine at
Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064,
USA. armstrong@usa.net
The basic etiology of neuropathic diabetic foot wounds involves pressure in
conjunction with cycles of repetitive stress, leading to failure of skin and soft
tissue. The central tenet of any treatment plan addressing neuropathic diabetic
foot wounds is the appropriate debridement of nonviable tissue coupled with
adequate pressure relief (off-loading). Although numerous advances have been made
in the treatment of diabetic foot wounds, including bioengineered tissues,
autologous and exogenous cytokine delivery systems, and potentially effective
topical antimicrobial modalities, none will succeed without addressing effective
debridement and off-loading. Specific debridement and off-loading techniques are
discussed, along with available supporting evidence. This includes the use of the
"instant" total contact cast, among other modalities.
DOI: 10.1086/383269
PMID: 15306986 [Indexed for MEDLINE]
