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      Current concepts for the evaluation and management of diabetic foot ulcers

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          Abstract

          • The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates.

          • More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation.

          • Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia.

          Cite this article: EFORT Open Rev 2018;3:513-525. DOI: 10.1302/2058-5241.3.180010

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          Most cited references88

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          Clinical application of growth factors and cytokines in wound healing.

          Wound healing is a complex and dynamic biological process that involves the coordinated efforts of multiple cell types and is executed and regulated by numerous growth factors and cytokines. There has been a drive in the past two decades to study the therapeutic effects of various growth factors in the clinical management of nonhealing wounds (e.g., pressure ulcers, chronic venous ulcers, diabetic foot ulcers). For this review, we conducted an online search of Medline/PubMed and critically analyzed the literature regarding the role of growth factors and cytokines in the management of these wounds. We focused on currently approved therapies, emerging therapies, and future research possibilities. In this review, we discuss four growth factors and cytokines currently being used on and off label for the healing of wounds. These include granulocyte-macrophage colony-stimulating factor, platelet-derived growth factor, vascular endothelial growth factor, and basic fibroblast growth factor. While the clinical results of using growth factors and cytokines are encouraging, many studies involved a small sample size and are disparate in measured endpoints. Therefore, further research is required to provide definitive evidence of efficacy. © 2014 by the Wound Healing Society.
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            IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes.

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              The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine.

              Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline.
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                Author and article information

                Journal
                EFORT Open Rev
                EFORT Open Rev
                EFORT Open Reviews
                British Editorial Society of Bone and Joint Surgery
                2058-5241
                September 2018
                27 September 2018
                : 3
                : 9
                : 513-525
                Affiliations
                [1 ]First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
                [2 ]Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
                Author notes
                [*]A. F. Mavrogenis, First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, 41 Ventouri Street, 15562 Holargos, Athens, Greece. Email: afm@ 123456otenet.gr
                Article
                10.1302_2058-5241.3.180010
                10.1302/2058-5241.3.180010
                6174858
                362c745a-fa43-453d-b02e-9a583f6ef0a3
                © 2018 The author(s)

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Foot & Ankle
                3
                Diabetic Foot Ulcers
                Infection
                Osteomyelitis
                Revascularization
                Wound Dressings

                diabetic foot ulcers,infection,osteomyelitis,revascularization,wound dressings

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