vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2021.1.PROT.1vmireaviz-145Research ArticleКлинические протоколыClinical ProtocolsПринципы диагностики и лечения раневого процесса у пациентов с синдромом диабетической стопы и групп риска. Проект рекомендацийDiagnostic and treatment principles of wound process in patients with diabetic foot syndrome and risk groups. Draft recommendationshttps://orcid.org/0000-0002-1350-0704СупильниковА. А.SupilnikovA. A.

Супильников Алексей Александрович, кандидат медицинских наук, доцент, первый проректор по научной деятельности, заведующий кафедрой морфологии и патологии

Самара

Samara

https://orcid.org/0000-0002-3052-0926КолесниковЕ. В.KolesnikovE. V.

Колесников Евгений Викторович, ассистент кафедры морфологии и патологии

Самара

Samara

https://orcid.org/0000-0002-4951-7735СтаростинаА. А.StarostinaA. A.

Старостина Анна Александровна, ассистент кафедры морфологии и патологии

Самара

Samara

https://orcid.org/0000-0002-6438-685XТрусоваЛ. А.TrusovaL. A.

Трусова Людмила Андреевна, врач-хирург, член комитета молодых онкологов RUSSCO

Самара

Samara

МихайловМ. С.MikhailovM. S.

Самара

Samara

https://orcid.org/0000-0003-4352-718XМанцаговаС. А.MantsagovaS. A.

Манцагова Светлана Александровна, врач-эндокринолог, главный внештатный специалист министерства здравоохранения Самарской области по эндокринологии

Самара

Samara

https://orcid.org/0000-0001-5889-8675ЯреминБ. И.YareminB. I.

Яремин Борис Иванович, кандидат медицинских наук, доцент, врач-хирург центра трансплантации печени НИИ скорой помощи имени Н.В. Склифосовского, председатель Самарского регионального отделения и член правления МОО «Общество трансплантологов»

Самара

Samara

Медицинский университет «Реавиз»РоссияMedical University “Reaviz”Russian FederationСамарский государственный медицинский университет МЗ РФRussian FederationSamara State Medical UniversityRussian FederationСамарская городская клиническая больница №1 им. Н.И. ПироговаRussian FederationSamara City Clinical Hospital № 1 named after N.I. PirogovRussian Federation20212003202101109123Copyright © Супильников А.А., Колесников Е.В., Старостина А.А., Трусова Л.А., Михайлов М.С., Манцагова С.А., Яремин Б.И., 20212021Супильников А.А., Колесников Е.В., Старостина А.А., Трусова Л.А., Михайлов М.С., Манцагова С.А., Яремин Б.И.Supilnikov A.A., Kolesnikov E.V., Starostina A.A., Trusova L.A., Mikhailov M.S., Mantsagova S.A., Yaremin B.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/145

Проект клинических рекомендаций разработан коллективом научной группы по лечению ран и раневого процесса Медицинского университета «Реавиз» с учётом современных научных данных, практического опыта и оригинальных исследований. Приводятся данные о формулировке диагноза при синдроме диабетической стопы, существующие классификации язв и ран, план обследования, базисной и дополнительной терапии, местного лечения язв и ран.

The draft clinical guidelines were developed by the team of the scientific group for the treatment of wounds and wound process of the Reaviz Medical University, taking into account modern scientific data, practical experience and original research. The data on the formulation of the diagnosis in diabetic foot syndrome, the existing classification of ulcers and wounds, the survey plan, basic and additional therapy, local treatment of ulcers and wounds are presented.

диабетическая стопадиабетическая полинейропатияатеросклерозdiabetic footdiabetic polyneuropathyatherosclerosisReferencesInternational Consensus and Guidelines on the Diabetic Foot. December 15, 1997; May, 1999. 2 Gur'eva I.V., Kuzina I.V., Voronin A.V. i dr. Sindrom diabeticheskoj stopy. Metodicheskie rekomendacii. Moscow, 2000. (In Russ).1 International Consensus and Guidelines on the Diabetic Foot. December 15, 1997; May, 1999. 2 Gur'eva I.V., Kuzina I.V., Voronin A.V. i dr. Sindrom diabeticheskoj stopy. Metodicheskie rekomendacii. Moscow, 2000. (In Russ).Gur'eva I.V., Komelyagina E.YU., Kuzina I.V. Diabeticheskaya perifericheskaya sensomotornaya nejropatiya. Patogenez, klinika i diagnostika. Metodicheskie rekomendacii. Moscow, 2000. (In Russ).3 Gur'eva I.V., Komelyagina E.YU., Kuzina I.V. Diabeticheskaya perifericheskaya sensomotornaya nejropatiya. Patogenez, klinika i diagnostika. Metodicheskie rekomendacii. Moscow, 2000. (In Russ).Prikaz MZ RF № 267 ot 16.07.2001 «O razvitii diabetologicheskoj pomoshchi naseleniyu Rossijskoj Federacii». (In Russ).4 Prikaz MZ RF № 267 ot 16.07.2001 «O razvitii diabetologicheskoj pomoshchi naseleniyu Rossijskoj Federacii». (In Russ).Kliniko-funkcional'nye osobennosti i mediko-social'naya reabilitaciya bol'nyh saharnym diabetom, oslozhnennym sindromom diabeticheskoj stopy. Ministerstvo social'noj zashchity naseleniya RF. Moscow, 1994. (In Russ).5 Kliniko-funkcional'nye osobennosti i mediko-social'naya reabilitaciya bol'nyh saharnym diabetom, oslozhnennym sindromom diabeticheskoj stopy. Ministerstvo social'noj zashchity naseleniya RF. Moscow, 1994. (In Russ).Algoritmy specializirovannoj medicinskoj pomoshchi bol'nym saharnym diabetom / pod red. I. I. Dedova, M.V. SHestakovoj. Moscow, 2015. 168 s. (In Russ).6 Algoritmy specializirovannoj medicinskoj pomoshchi bol'nym saharnym diabetom / pod red. I. I. Dedova, M.V. SHestakovoj. Moscow, 2015. 168 s. (In Russ).Saharnyj diabet. Ostrye i hronicheskie oslozhneniya / pod red. I. I. Dedova, M. V. SHestakovoj. Moscow, 2011. 477 s. (In Russ).7 Saharnyj diabet. Ostrye i hronicheskie oslozhneniya / pod red. I. I. Dedova, M. V. SHestakovoj. Moscow, 2011. 477 s. (In Russ).Udovichenko O.V., Bublik E.V., Maksimova N.V., Pryahina K.YU., Ermolaeva O.S., Spruit P., Galstyan G.R. Effektivnost' immobiliziruyushchih razgruzochnyh povyazok Total Contact Cast: obzor zarubezhnyh randomizirovannyh klinicheskih issledovanij i sobstvennye dannye. Saharnyj diabet. 2010;2:50-55. (In Russ).8 Udovichenko O.V., Bublik E.V., Maksimova N.V., Pryahina K.YU., Ermolaeva O.S., Spruit P., Galstyan G.R. Effektivnost' immobiliziruyushchih razgruzochnyh povyazok Total Contact Cast: obzor zarubezhnyh randomizirovannyh klinicheskih issledovanij i sobstvennye dannye. Saharnyj diabet. 2010;2:50-55. (In Russ).Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U. K. Diabetes Care. 2011 Oct;34(10):2220-4.9 Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U. K. Diabetes Care. 2011 Oct;34(10):2220-4.Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG, Woo K, Boeni T, Ayello EA, Kirsner RS. Diabetic foot ulcers: Part I. Pathophysiology and prevention. J Am Acad Dermatol. 2014 Jan;70(1):1.E1-18.10 Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG, Woo K, Boeni T, Ayello EA, Kirsner RS. Diabetic foot ulcers: Part I. Pathophysiology and prevention. J Am Acad Dermatol. 2014 Jan;70(1):1.E1-18.Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG, Woo K, Boeni T, Ayello EA, Kirsner RS. Diabetic foot ulcers: Part II. Management. J Am Acad Dermatol. 2014 Jan;70(1):21.E1-24.11 Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG, Woo K, Boeni T, Ayello EA, Kirsner RS. Diabetic foot ulcers: Part II. Management. J Am Acad Dermatol. 2014 Jan;70(1):21.E1-24.Armstrong DG, Mills JL. Toward a change in syntax in diabetic foot care: prevention equals remission. J Am Pod Med Assoc. 2013;103:161–2.12 Armstrong DG, Mills JL. Toward a change in syntax in diabetic foot care: prevention equals remission. J Am Pod Med Assoc. 2013;103:161–2.Armstrong DG. An overview of foot infections in diabetes Diabetes Technol Ther 2011 Sep;13(9):951-7.13 Armstrong DG. An overview of foot infections in diabetes Diabetes Technol Ther 2011 Sep;13(9):951-7.Bakker K, Apelqvist J, Schaper NC. Practical guidelines on the management and prevention of the diabetic foot 2011. Diab Metab Res Rev. 2012;28(Suppl 1):225–231.14 Bakker K, Apelqvist J, Schaper NC. Practical guidelines on the management and prevention of the diabetic foot 2011. Diab Metab Res Rev. 2012;28(Suppl 1):225–231.Barshes NR, Sigireddi M, Wrobel JS, Mahankali A, Robbins JM, Kougias P, Armstrong DG. The system of care for the diabetic foot: objectives, outcomes, and opportunities Diabet Foot Ankle 2013 Oct 10;4. Doi: 10,3402/dfav4i0,21847. ECollection 2013.15 Barshes NR, Sigireddi M, Wrobel JS, Mahankali A, Robbins JM, Kougias P, Armstrong DG. The system of care for the diabetic foot: objectives, outcomes, and opportunities Diabet Foot Ankle 2013 Oct 10;4. Doi: 10,3402/dfav4i0,21847. ECollection 2013.Bongaerts BW, Rathmann W, Heier M, Kowall B, Herder C, Stöckl D, et al Older subjects with diabetes and prediabetes are frequently unaware of having distal sensorimotor polyneuropathy: The KORA F4 study. Diabetes Care. 2013;36:1141–6.16 Bongaerts BW, Rathmann W, Heier M, Kowall B, Herder C, Stöckl D, et al Older subjects with diabetes and prediabetes are frequently unaware of having distal sensorimotor polyneuropathy: The KORA F4 study. Diabetes Care. 2013;36:1141–6.Bradbury AW. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial in perspective. J Vasc Surg. 2010;51(5 Suppl):1S–4S.17 Bradbury AW. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial in perspective. J Vasc Surg. 2010;51(5 Suppl):1S–4S.Cavanagh PR, Bus SA. Off-loading the diabetic foot for ulcer prevention and healing. Plast Reconstr Surg. 2011 Jan;127 Suppl 1:248S-256S.18 Cavanagh PR, Bus SA. Off-loading the diabetic foot for ulcer prevention and healing. Plast Reconstr Surg. 2011 Jan;127 Suppl 1:248S-256S.Clemens MW, Attinger CE. Angiosomes and wound care in the diabetic foot. Foot Ankle Clin. 2010 Sep;15(3):439-64.19 Clemens MW, Attinger CE. Angiosomes and wound care in the diabetic foot. Foot Ankle Clin. 2010 Sep;15(3):439-64.Dorresteijn JA, Kriegsman DM, Assendelft WJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev. 2012;10:CD001488.20 Dorresteijn JA, Kriegsman DM, Assendelft WJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev. 2012;10:CD001488.Edwards J, Stapley S. Debridement of diabetic foot ulcers. Cochrane Database Syst Rev. 2010:CD003556.21 Edwards J, Stapley S. Debridement of diabetic foot ulcers. Cochrane Database Syst Rev. 2010:CD003556.Feinglass J, Shively VP, Martin GJ, Huang ME, Soriano RH, Rodriguez HE, et al How „preventable‟ are lower extremity amputations? A qualitative study of patient perceptions of precipitating factors. Disabil Rehabil. 2012;34:2158–65.22 Feinglass J, Shively VP, Martin GJ, Huang ME, Soriano RH, Rodriguez HE, et al How „preventable‟ are lower extremity amputations? A qualitative study of patient perceptions of precipitating factors. Disabil Rehabil. 2012;34:2158–65.Fincke BG, Miller DR, Christiansen CL, Turpin RS. Variation in antibiotic treatment for diabetic patients with serious foot infections: a retrospective observational study. BMC Health Serv Res. 2010;10:193.23 Fincke BG, Miller DR, Christiansen CL, Turpin RS. Variation in antibiotic treatment for diabetic patients with serious foot infections: a retrospective observational study. BMC Health Serv Res. 2010;10:193.Frykberg RG, Bevilacqua NJ, Habershaw G. Surgical off-loading of the diabetic foot. J Vasc Surg. 2010;52(3 Suppl):44S-58.24 Frykberg RG, Bevilacqua NJ, Habershaw G. Surgical off-loading of the diabetic foot. J Vasc Surg. 2010;52(3 Suppl):44S-58.Fusilli D, Alviggi L, Seghieri G, Bellis A. Improvement of diabetic foot care after the implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study. Diabetes Res Clin Pract. 2007;75:153-158.25 Fusilli D, Alviggi L, Seghieri G, Bellis A. Improvement of diabetic foot care after the implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study. Diabetes Res Clin Pract. 2007;75:153-158.Gordon KA, Lebrun EA, Tomic-Canic M, Kirsner RS. The role of surgical debridement in healing of diabetic foot ulcers. Skinmed. 2012 Jan-Feb;10(1):24-6.26 Gordon KA, Lebrun EA, Tomic-Canic M, Kirsner RS. The role of surgical debridement in healing of diabetic foot ulcers. Skinmed. 2012 Jan-Feb;10(1):24-6.Gottrup F. (Editor), Apelqvist J. (Co-editor), Bjansholt T. , Cooper R. , Moore Z. , et al EWMA Document: Antimicrobials and Non-healing Wounds Evidence, controversies and suggestions. Journal of Wound Care. 2013;22(5) (EWMA Document).27 Gottrup F. (Editor), Apelqvist J. (Co-editor), Bjansholt T. , Cooper R. , Moore Z. , et al EWMA Document: Antimicrobials and Non-healing Wounds Evidence, controversies and suggestions. Journal of Wound Care. 2013;22(5) (EWMA Document).Henry AJ, Hevelone ND, Belkin M, Nguyen LL. Socioeconomic and hospital-related predictors of amputation for critical limb ischemia. J Vasc Surg. 2011;53:330–9.28 Henry AJ, Hevelone ND, Belkin M, Nguyen LL. Socioeconomic and hospital-related predictors of amputation for critical limb ischemia. J Vasc Surg. 2011;53:330–9.Jones WS, Patel MR, Dai D, Subherwal S, Stafford J, Calhoun S, et al Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U. S. Medicare 2000–2008. J Am Coll Cardiol. 2012;60:2230–6.29 Jones WS, Patel MR, Dai D, Subherwal S, Stafford J, Calhoun S, et al Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U. S. Medicare 2000–2008. J Am Coll Cardiol. 2012;60:2230–6.Katon JG, Reiber GE, Nelson KM. Peripheral neuropathy defined by monofilament insensitivity and diabetes status: NHANES 1999-2004. Diabetes Care. 2013 Jun;36(6):1604-6.30 Katon JG, Reiber GE, Nelson KM. Peripheral neuropathy defined by monofilament insensitivity and diabetes status: NHANES 1999-2004. Diabetes Care. 2013 Jun;36(6):1604-6.Landsman A, Agnew P, Parish L, Joseph R, Galiano RD. Diabetic foot ulcers treated with becaplermin and TheraGauze, a moisture-controlling smart dressing: a randomized, multicenter, prospective analysis. J Am Podiatr Med Assoc. 2010;100:155–60.31 Landsman A, Agnew P, Parish L, Joseph R, Galiano RD. Diabetic foot ulcers treated with becaplermin and TheraGauze, a moisture-controlling smart dressing: a randomized, multicenter, prospective analysis. J Am Podiatr Med Assoc. 2010;100:155–60.Lavery LA, Higgins KR, La Fontaine J, Zamorano RG, Constantinides GP, Kim PJ. Randomised clinical trial to compare total contact casts, healing sandals and a shear-reducing removable boot to heal diabetic foot ulcers. Int Wound J. 2014 Feb 21. Doi: 10,1111/iwj12213. [Epub ahead of print].32 Lavery LA, Higgins KR, La Fontaine J, Zamorano RG, Constantinides GP, Kim PJ. Randomised clinical trial to compare total contact casts, healing sandals and a shear-reducing removable boot to heal diabetic foot ulcers. Int Wound J. 2014 Feb 21. Doi: 10,1111/iwj12213. [Epub ahead of print].Lavery LA, Higgins KR, La Fontaine J, Zamorano RG, Constantinides GP, Kim PJ. Randomised clinical trial to compare total contact casts, healing sandals and a shear-reducing removable boot to heal diabetic foot ulcers Int Wound J. 2014 Feb 21. https://doi.org/10,1111/iwj12213. [Epub ahead of print].33 Lavery LA, Higgins KR, La Fontaine J, Zamorano RG, Constantinides GP, Kim PJ. Randomised clinical trial to compare total contact casts, healing sandals and a shear-reducing removable boot to heal diabetic foot ulcers Int Wound J. 2014 Feb 21. https://doi.org/10,1111/iwj12213. [Epub ahead of print].Lewis J, Lipp A. Pressure-relieving interventions for treating diabetic foot ulcers. Cochrane Database Syst Rev. 2013 Jan 31;1:CD002302.34 Lewis J, Lipp A. Pressure-relieving interventions for treating diabetic foot ulcers. Cochrane Database Syst Rev. 2013 Jan 31;1:CD002302.Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG, Embil JM, Joseph WS, Karchmer AW, Pinzur MS, Senneville E. 2012 infectious diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections. J Am Podiatr Med Assoc. 2013 Jan-Feb;103(1):2-7.35 Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG, Embil JM, Joseph WS, Karchmer AW, Pinzur MS, Senneville E. 2012 infectious diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections. J Am Podiatr Med Assoc. 2013 Jan-Feb;103(1):2-7.Benjamin A. Lipsky, Anthony R. Berendt, Paul B. Cornia, James C. Pile, Edgar J. G. Peters, David G. Armstrong6, H. Gunner Deery7, John M. Embil8, Warren S. Joseph, Adolf W. Karchmer, Michael S. Pinzur, and Eric Senneville Clin Infect Dis.2012;54(12):1679-1684.36 Benjamin A. Lipsky, Anthony R. Berendt, Paul B. Cornia, James C. Pile, Edgar J. G. Peters, David G. Armstrong6, H. Gunner Deery7, John M. Embil8, Warren S. Joseph, Adolf W. Karchmer, Michael S. Pinzur, and Eric Senneville Clin Infect Dis.2012;54(12):1679-1684.López-de-Andrés A, Martínez-Huedo MA, Carrasco-Garrido P, Hernández-Barrera V, Gil-de-Miguel A, Jiménez- García R. Trends in lower-extremity amputations in people with and without diabetes in Spain, 2001– 2008. Diabetes Care. 2011;34:1570–6.37 López-de-Andrés A, Martínez-Huedo MA, Carrasco-Garrido P, Hernández-Barrera V, Gil-de-Miguel A, Jiménez- García R. Trends in lower-extremity amputations in people with and without diabetes in Spain, 2001– 2008. Diabetes Care. 2011;34:1570–6.Molines L, Darmon P, Raccah D. Charcot s foot: newest findings on its pathophysiology, diagnosis and treatment. Diabetes Metab. 2010 Sep;36(4):251-5.38 Molines L, Darmon P, Raccah D. Charcot s foot: newest findings on its pathophysiology, diagnosis and treatment. Diabetes Metab. 2010 Sep;36(4):251-5.Monteiro-Soares M1, Martins-Mendes D, Vaz-Carneiro A, Sampaio S, Dinis-Ribeiro M. Classification systems for lower extremity amputation prediction in subjects with active diabetic foot ulcer: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2014 Feb 12. https://doi.org/10,1002/dmrr2535. [Epub ahead of print].39 Monteiro-Soares M1, Martins-Mendes D, Vaz-Carneiro A, Sampaio S, Dinis-Ribeiro M. Classification systems for lower extremity amputation prediction in subjects with active diabetic foot ulcer: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2014 Feb 12. https://doi.org/10,1002/dmrr2535. [Epub ahead of print].Morbach S, Furchert H, Gröblinghoff U, Hoffmeier H, Kersten K, Klauke GT, Klemp U, Roden T, Icks A, Haastert B, Rümenapf G, Abbas ZG, Bharara M, Armstrong DG. Diabetes Care Long-term prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade 2012 Oct;35(10):2021-7. Epub 2012 Jul 18.40 Morbach S, Furchert H, Gröblinghoff U, Hoffmeier H, Kersten K, Klauke GT, Klemp U, Roden T, Icks A, Haastert B, Rümenapf G, Abbas ZG, Bharara M, Armstrong DG. Diabetes Care Long-term prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade 2012 Oct;35(10):2021-7. Epub 2012 Jul 18.Ndip A, Rutter MK, Vileikyte L, Vardhan A, Asari A, Jameel M, et al Dialysis treatment is an independent risk factor for foot ulceration in patients with diabetes and stage 4 or 5 chronic kidney disease. Diabetes Care. 2010;33:1811–6.41 Ndip A, Rutter MK, Vileikyte L, Vardhan A, Asari A, Jameel M, et al Dialysis treatment is an independent risk factor for foot ulceration in patients with diabetes and stage 4 or 5 chronic kidney disease. Diabetes Care. 2010;33:1811–6.Percival SL, Hill KE, Williams DW, Hooper SJ, Thomas DW, Costerton JW. A review of the scientific evidence for biofilms in wounds. Wound Repair Regen. 2012 Sep-Oct;20(5):647-57.42 Percival SL, Hill KE, Williams DW, Hooper SJ, Thomas DW, Costerton JW. A review of the scientific evidence for biofilms in wounds. Wound Repair Regen. 2012 Sep-Oct;20(5):647-57.Peters EJ, Lipsky BA. Diagnosis and management of infection in the diabetic foot. Med Clin North Am. 2013 Sep;97(5):911-46.43 Peters EJ, Lipsky BA. Diagnosis and management of infection in the diabetic foot. Med Clin North Am. 2013 Sep;97(5):911-46.Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000 May;23(5):606-11.44 Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000 May;23(5):606-11.Potier L, Abi Khalil C, Mohammedi K, Roussel R. Use and utility of ankle brachial index in patients with diabetes. Eur J Vasc Endovasc Surg. 2011;41:110–16.45 Potier L, Abi Khalil C, Mohammedi K, Roussel R. Use and utility of ankle brachial index in patients with diabetes. Eur J Vasc Endovasc Surg. 2011;41:110–16.Regenbogen SE, Gawande AA, Lipsitz SR, Greenberg CC, Jha AK. Do differences in hospital and surgeon quality explain racial disparities in lower-extremity vascular amputations? Ann Surg. 2009;250:424–31.46 Regenbogen SE, Gawande AA, Lipsitz SR, Greenberg CC, Jha AK. Do differences in hospital and surgeon quality explain racial disparities in lower-extremity vascular amputations? Ann Surg. 2009;250:424–31.Schaper NC, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, et al Specific guidelines for the diagnosis and treatment of peripheral arterial disease in a patient with diabetes and ulceration of the foot 2011. Diabetes Metab Res Rev. 2012;28(Suppl 1):236–7.47 Schaper NC, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, et al Specific guidelines for the diagnosis and treatment of peripheral arterial disease in a patient with diabetes and ulceration of the foot 2011. Diabetes Metab Res Rev. 2012;28(Suppl 1):236–7.Schaper NC, Apelqvist J, Bakker K. Reducing lower leg amputations in diabetes: a challenge for patients, healthcare providers and the healthcare system. Diabetologia. 2012 Jul;55(7):1869-72.48 Schaper NC, Apelqvist J, Bakker K. Reducing lower leg amputations in diabetes: a challenge for patients, healthcare providers and the healthcare system. Diabetologia. 2012 Jul;55(7):1869-72.Sibbald RG, Ayello EA, Alavi A, Ostrow B, Lowe J, Botros M, Goodman L, Woo K, Smart H. Screening for the high-risk diabetic foot: a 60-second tool (2012). Adv Skin Wound Care. 2012 Oct;25(10):465-76; quiz 477-8.49 Sibbald RG, Ayello EA, Alavi A, Ostrow B, Lowe J, Botros M, Goodman L, Woo K, Smart H. Screening for the high-risk diabetic foot: a 60-second tool (2012). Adv Skin Wound Care. 2012 Oct;25(10):465-76; quiz 477-8.Snyder RJ, Cardinal M, Dauphinée DM, Stavosky J. A post-hoc analysis of reduction in diabetic foot ulcer size at 4 weeks as a predictor of healing by 12 weeks. Ostomy Wound Manage. 2010 Mar 1;56(3):44-50.50 Snyder RJ, Cardinal M, Dauphinée DM, Stavosky J. A post-hoc analysis of reduction in diabetic foot ulcer size at 4 weeks as a predictor of healing by 12 weeks. Ostomy Wound Manage. 2010 Mar 1;56(3):44-50.Snyder RJ, Kirsner RS, Warriner RA 3rd, Lavery LA, Hanft JR, Sheehan P. Consensus recommendations on advancing the standard of care for treating neuropathic foot ulcers in patients with diabetes. Ostomy Wound Manage. 2010 Apr;56(4 Suppl):S1-24.51 Snyder RJ, Kirsner RS, Warriner RA 3rd, Lavery LA, Hanft JR, Sheehan P. Consensus recommendations on advancing the standard of care for treating neuropathic foot ulcers in patients with diabetes. Ostomy Wound Manage. 2010 Apr;56(4 Suppl):S1-24.Sumpio BE, Armstrong DG, Lavery LA, Andros G ; Society for Vascular Surgery ; American Podiatric Medical Association. The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association. J Am Podiatr Med Assoc. 2010 Jul-Aug;100(4):309-11.52 Sumpio BE, Armstrong DG, Lavery LA, Andros G ; Society for Vascular Surgery ; American Podiatric Medical Association. The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association. J Am Podiatr Med Assoc. 2010 Jul-Aug;100(4):309-11.Taylor SM, Johnson BL, Samies NL, Rawlinson RD, Williamson LE, Davis SA, Kotrady JA, York JW, Langan EM, 3rd, Cull DL. Contemporary management of diabetic neuropathic foot ulceration: a study of 917 consecutively treated limbs. J Am Coll Surg. 2011;212(4):532–548.53 Taylor SM, Johnson BL, Samies NL, Rawlinson RD, Williamson LE, Davis SA, Kotrady JA, York JW, Langan EM, 3rd, Cull DL. Contemporary management of diabetic neuropathic foot ulceration: a study of 917 consecutively treated limbs. J Am Coll Surg. 2011;212(4):532–548.Wukich DK, Armstrong DG, Attinger CE, Boulton AJ, Burns PR, Frykberg RG, Hellman R, Kim PJ, Lipsky BA, Pile JC, Pinzur MS, Siminerio L. Inpatient management of diabetic foot disorders: a clinical guide. Diabetes Care. 2013 Sep;36(9):2862-71.54 Wukich DK, Armstrong DG, Attinger CE, Boulton AJ, Burns PR, Frykberg RG, Hellman R, Kim PJ, Lipsky BA, Pile JC, Pinzur MS, Siminerio L. Inpatient management of diabetic foot disorders: a clinical guide. Diabetes Care. 2013 Sep;36(9):2862-71.Wukich DK, Armstrong DG, Attinger CE, Boulton AJ, Burns PR, Frykberg RG, Hellman R, Kim PJ, Lipsky BA, Pile JC, Pinzur MS, Siminerio L. Inpatient management of diabetic foot disorders: a clinical guide. Diabetes Care. 2013 Sep;36(9):2862-71.55 Wukich DK, Armstrong DG, Attinger CE, Boulton AJ, Burns PR, Frykberg RG, Hellman R, Kim PJ, Lipsky BA, Pile JC, Pinzur MS, Siminerio L. Inpatient management of diabetic foot disorders: a clinical guide. Diabetes Care. 2013 Sep;36(9):2862-71.World Union of Wound Healing Societies (WUWHS) «Principles of best practice: Wound exudate and the role of dressings». A consensus document London: MEP Ltd, 2007.56 World Union of Wound Healing Societies (WUWHS) «Principles of best practice: Wound exudate and the role of dressings». A consensus document London: MEP Ltd, 2007.World Union of Wound Healing Societies (WUWHS). Minimising pain at wound dressing-related procedures A consensus document Toronto, Ontario, Canada: Wound Pedia Inc, 2007.57 World Union of Wound Healing Societies (WUWHS). Minimising pain at wound dressing-related procedures A consensus document Toronto, Ontario, Canada: Wound Pedia Inc, 2007.World Union of Wound Healing Societies (WUWHS) «Local management of diabetic foot ulcers». Position document Florence: Wounds international, 2016.58 World Union of Wound Healing Societies (WUWHS) «Local management of diabetic foot ulcers». Position document Florence: Wounds international, 2016.

The authors declare that there are no conflicts of interest present.