The Diabetic Foot: A Historical Overview and Gaps in Current Treatment

Abstract

Significance: The number of patients with diabetes is rapidly increasing around the world. A large percentage of this population can be expected to develop diabetic ulcers. The economic, social, and public health burden of these ulcers is enormous. It is a common problem that is tackled every day by many healthcare workers throughout the world. Recent Advances: Many pioneers contributed to the good standard of care we have today when treating diabetes and its complications. Current treatment of diabetic foot ulcers involves a multidisciplinary team approach, controls the underlying disease, and treats the wounds using debridement, different wound dressings, and redistributes pressure off the wound. Critical Issues: Since the discovery of the association between diabetes and gangrene of the foot 160 years ago, there have been developments and milestones that are the base of our treatment today. However, with all the modern wound treatment available today, there is a group of patients with hard-to-heal ulcers who do not seem to respond to the regular treatment. Future Directions: It is clear that more research has to be done to improve techniques that will enhance wound healing in chronic wounds. Innovative techniques will be discussed and outlined in this article.

Caroline C.L.M. Naves, MD

Figure 1.

Typical chronic ulceration in a patient with diabetes. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound