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Pathophysiology and Principles of Management of the Diabetic Foot

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Mechanisms of Vascular Disease

Abstract

Diabetic foot complications are the main cause of non-traumatic lower limb amputation internationally. Most amputations in diabetes are preceded by foot ulceration. Therefore, a thorough understanding of the causes, assessment and management of ulceration is essential. This chapter provides a concise description of the key factors contributing to the pathophysiology of the diabetic foot. The chapter also outlines an evidence-based approach to the clinical assessment and management based on recently published guidelines.

The importance of assessment of the limb by evaluating the presence and severity of wound(s), ischaemia and foot infection is emphasised. This assessment will direct therapeutic strategies such as offloading, treatment of peripheral artery disease and treatment of infection. The chapter also provides a description of the diagnosis of osteomyelitis in the diabetic foot and discusses briefly Charcot neuroarthropathy. Finally, it highlights the importance of preventive strategies which are essential to reducing the morbidity and mortality of diabetic foot complications.

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Authors and Affiliations

  1. Discipline of Surgery, The University of Adelaide, Adelaide, SA, Australia

    Guilherme Pena & Robert Fitridge

  2. Vascular and Endovascular Service, Royal Adelaide Hospital, Adelaide, SA, Australia

    Guilherme Pena & Robert Fitridge

  3. Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    David G. Armstrong

  4. Vascular and Endovascular Surgery, DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Joseph L. Mills

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    Robert Fitridge

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Pena, G., Armstrong, D.G., Mills, J.L., Fitridge, R. (2020). Pathophysiology and Principles of Management of the Diabetic Foot. In: Fitridge, R. (eds) Mechanisms of Vascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-43683-4_26

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