Treatment algorithm for diabetic ulcers
Treatment algorithm for diabetic ulcers Treatment - Diabetic Foot Ulcers Treatment - Diabetic Foot Ulcers
«Flowchart»


Establish etiology.
Review past medical treatments.
Review medication history.
Perform noninvasive vascular assessment.
Evalute the patient's footwear.


Establish etiology.
Review past medical treatments.
Review medication history.
Perform noninvasive vascular assessment.
Evalute the patient's footwear.


Establish etiology.
Review past medical treatments.
Review medication history.
Perform noninvasive vascular assessment.
Evalute the patient's footwear.


Establish etiology.
Review past medical treatments.
Review medication history.
Perform noninvasive vascular assessment.
Evalute the patient's footwear.

Ischemic: Ankle-brachial index < 0.8 Vascular consult(if indicated)

Ischemic: Ankle-brachial index < 0.8 Vascular consult(if indicated)

Ischemic Vascular consult Vascular consult Ischemic: Ankle-brachial index < 0.8

Neuropathic: Ankle-brachial index >0.9 Assess degree of neuropathy

Neuropathic: Ankle-brachial index >0.9 Assess degree of neuropathy

Neuropathic Assess degree of neuropathy Assess degree of neuropathy Neuropathic: Ankle-brachial index >0.9

Wound care

Wound care

Wound care

Wound care

Localized soft tissue


Broad-spectrum oral antibiotics
Reevaluation in 1 week
Non-weight-bearing activity (if possible)
Control of diabetes

Localized soft tissue


Broad-spectrum oral antibiotics
Reevaluation in 1 week
Non-weight-bearing activity (if possible)
Control of diabetes

Localized soft tissue

Localized soft tissue


Broad-spectrum oral antibiotics
Reevaluation in 1 week
Non-weight-bearing activity (if possible)
Control of diabetes


Broad-spectrum oral antibiotics
Reevaluation in 1 week
Non-weight-bearing activity (if possible)
Control of diabetes

Localized bone; systemic


Admission to hospital
Appropriate cultures
I.V. antibiotics
Possibly, surgical intervention

Localized bone; systemic


Admission to hospital
Appropriate cultures
I.V. antibiotics
Possibly, surgical intervention

Localized bone; systemic

Localized bone; systemic


Admission to hospital
Appropriate cultures
I.V. antibiotics
Possibly, surgical intervention


Admission to hospital
Appropriate cultures
I.V. antibiotics
Possibly, surgical intervention

Infection?

Infection?

Infection?

Infection?

Yes

Yes

Yes Yes

No

No

No No

Yes

Yes

Yes Yes

End

End

End

Debridement

Debridement

Debridement

Debridement

Ischemic, stable


Nonaggressive dressing treatment

Ischemic, stable

Ischemic, stable


Nonaggressive dressing treatment


Nonaggressive dressing treatment Ischemic, stable

Nonischemic, neuropathic


Debride hyperkeratotic rim
Perform aggressive sharp debridement

Nonischemic, neuropathic

Nonischemic, neuropathic


Debride hyperkeratotic rim
Perform aggressive sharp debridement


Debride hyperkeratotic rim
Perform aggressive sharp debridement Nonischemic, neuropathic