Management of a Diabetic Foot

GUIDELINE TITLE Management of a Diabetic Foot DEVELOPER Society for Vascular Surgery (SVS), American Pediatric Medical Association, Society for Vascular Medicine RELEASE DATE February 2016 FUNDING SOURCE SVS TARGET POPULATION All patients with diabetes MAJOR RECOMMENDATIONS AND RATINGS (1) Annual foot inspections by physicians or advanced practice dinicians with training in foot care and education of patients and their families about preventive foot care are recommended for patients with diabetes (grade 1C). (2) Foot examinations in patients with diabetes should inlcude testing for peripheral neuropathy using the Semmes-Weinstein test (grade 1B). (3) Annual assessment is recommended of pedal perfusion by ankle-brachial index (ABI), ankle and pedal Doppler arterial waveforms, and either toe systolic pressure or transcutaneous oxygen pressure (TcPo2) for patients with a current diabetic foot ulcer (DFU) (grade 1B). (4) Adequate glycemic control (hemoglobin A(1C) <7%) should be achieved to reduce DFUs and infections with subsequent risk of amputation (grade 2B). (5) Revascularization by surgical by pass or endovascular therapy is recommended for patients with DFU and peripheral arterial disease (PAD) (grade 1B). (6) Prophylactic arterial revascularization to prevent DFUs should not be done (grade 1C).