Crawford PE, Fields-Varnado M, WOCN Society., et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2013 Jan 1;volume 40(1):34-45.
1. J Wound Ostomy Continence Nurs. 2013 Jan-Feb;40(1):34-45. doi:
10.1097/WON.0b013e3182750161.
Guideline for the management of wounds in patients with lower-extremity
neuropathic disease: an executive summary.
Crawford PE(1), Fields-Varnado M; WOCN Society.
Author information:
(1)Atlantic Shores Wellness Clinic, Virginia Beach, VA, USA.
This article summarizes the WOCN Evidence-Based Clinical Practice Guideline for
Management of Wounds in Patients with Lower Extremity Neuropathic Disease. It is
intended for use by physicians, nurses, therapists, and other health care
professionals who work with adults who have or are at risk for, lower-extremity
neuropathic disease (LEND), and includes updated scientific literature available
from January 2003 through February 2012. The full guideline contains definitions
of lower extremity neuropathic disorders and disease, prevalence of the problem,
relevance and significance of the disorders, as well as comprehensive information
about etiology, the nervous system, pathogenesis, and the overall management
goals for patients at risk for developing neuropathic foot ulcers. A detailed
assessment section describes how to conduct a full clinical history and physical
examination. The guideline also provides two approaches to interventions. The
first focuses on prevention strategies to reduce the risk of developing LEND
wounds or recurrence, including life-long foot offloading, routine dermal
temperature surveillance, use of adjunctive therapies, medication management, and
implementing lower extremity amputation prevention measures and patient self-care
education. The second approach summarized LEND wound management strategies
including wound cleansing, debridement, infection management, maintenance of
intact peri-wound skin, nutrition considerations, pain and paresthesia
management, edema management, offloading and management of gait and foot
deformity, medication management, surgical options, adjunctive therapies, patient
education, and health care provider follow-up. A comprehensive reference list,
glossary of terms, and several appendices regarding an algorithm to determine
wound etiology, pharmacology, Lower Extremity Amputation (LEAP) Program, diabetes
foot screening and other information is available at the end of the guideline.
DOI: 10.1097/WON.0b013e3182750161
PMID: 23222969 [Indexed for MEDLINE]
