Novel therapeutic modalities of Diabetic foot syndrome

Diabetic foot syndrome is one of the most serious long-term complication of diabetes mellitus. The healing of foot ulcers is limited by multiple factors and therefore requires a multifactorial approach. The reduction of pressure to the neuropatic foot ulcer is essential for treatment and total contact cast is the standard method. In the management of ischaemic ulcers the revascularisation should be performed at first. Effective debridement including biological methods (larval therapy) in the treatment of local chronic wounds has been long established. Hydrosurgery using the „Versajet“ system is a latest method indicated for debridement. Advanced wound care modalities include local application of growth factors, skin substitutes, new wound dressings and, prospectively, stem cells. Surgical management techniques include urgent, curative and prophylactic surgery. Vacuum assissted closure (V. A. C) is another treatment modality for healing both post-operative wounds and chronic diabetic ulcers. The aim of Charcot foot treatment is to limit weight bearing with an effective off-loading in order to prevent severe deformity. Additionaly, the role of bisphosphonate or calcitonin treatment should be further evaluated. Control of infection is another essential component in diabetic foot management. Specialized management of diabetic foot syndrome is performed by multidisciplinary team at a foot clinic.

Keywords: diabetic foot, local wound management, Charcot osteoarthropathy