Having a diabetic foot ulcer (DFU) dramatically increases the risk for amputation, cardiovascular disease (CVD) and premature death. The reason is a higher presence of neuropathy, immunopathy, metabolic issues as well as a more distal and aggressive form of peripheral arterial disease. Time to diagnosis is crucial if the limb is to be saved. The classic signs such as claudication, rest pain or low ankle-brachial index (ABI) is therefore unlikely to be found in this patient population. Instead, look to the WIfI classification that is by far the most suitable method to assess a non-healing DFU1.
The ischemia in these patients is best evaluated with toe pressure, tcpO2 or a combination of both to get the most complete perfusion assessment.
- DFU increases the risk for amputation, CVD and even death.
- DFU is different from a purely ischemic ulcer and needs to be treated differently.
- “Time is tissue”, so early detection with toe pressure and tcpO2 is crucial.