Wound management of chronic diabetic foot ulcers: From the basics to regenerative medicine

Karen L. Andrews, Matthew T. Houdek, Lester J. Kiemele

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations


Background: Hospital-based studies have shown that mortality rates in individuals with diabetic foot ulcers are about twice those observed in individuals with diabetes without foot ulcers. Objective: To assess the etiology and management of chronic diabetic foot ulcers. Study design: Literature review. Methods: Systematic review of the literature discussing management of diabetic foot ulcers. Since there were only a few randomized controlled trials on this topic, articles were selected to attempt to be comprehensive rather than a formal assessment of study quality. Results: Chronic nonhealing foot ulcers occur in approximately 15% of patients with diabetes. Many factors contribute to impaired diabetic wound healing. Risk factors include peripheral neuropathy, peripheral arterial disease, limited joint mobility, foot deformities, abnormal foot pressures, minor trauma, a history of ulceration or amputation, and impaired visual acuity. With the current treatment for nonhealing diabetic foot ulcers, a significant number of patients require amputation. Conclusion: Diabetic foot ulcers are optimally managed by a multidisciplinary integrated team. Offloading and preventative management are important. Dressings play an adjunctive role. There is a critical need to develop novel treatments to improve healing of diabetic foot ulcers. The goal is to have wounds heal and remain healed.

Original languageEnglish (US)
Pages (from-to)29-39
Number of pages11
JournalProsthetics and Orthotics International
Issue number1
StatePublished - Feb 2015


  • Diabetes
  • Diabetic foot ulcer
  • Neuropathy
  • Wounds

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Rehabilitation


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