Current Concepts In Diagnosing Chronic Diabetic Foot Ulcerations

Molly Judge, DPM, FACFAS

2. Be sure to classify the wound type for documentation purposes as this will directly correlate with the treatment plan you select. In the event that the conservative wound care plan is not successful, then it is important to question the working diagnosis and wound classification. In fact, this may well be the time to consider a second opinion.

3. Determining whether there is an organism interfering with wound healing is important as bacterial colonization and infection commonly interfere with wound healing, and at times can be indolent with subtle outward signs of change. There are numerous methods to reduce bacterial load in a wound bed and when this is a problem, modifying the debridement method and/or the wound care plan are in order.

4. Understand the nature of the most common diabetic dermatopathology as this is often a coexisting and confounding factor when dealing with the chronic ulceration in patients with diabetes.

   Dr. Judge is a Fellow of the American College of Foot and Ankle Surgeons. She is in private practice at North West Ohio Foot and Ankle Institute, serving Ohio and Michigan. Dr. Judge is an adjunct faculty member at Ohio University and the Kent State University College of Podiatric Medicine. She is also on the faculty for graduate medical education at Mercy Health Partners in Toledo, Ohio.

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