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Driver VR, Fabbi M, Lavery LA The costs of diabetic foot: the economic case for the limb salvage team. Journal of Vascular Surgery. 2010; 52:17s-22s https://doi.org/10.1016/j.jvs.2010.06.003

Alshammary S, Othman SA, Alshammari E Economic impact of diabetic foot ulcers on healthcare in Saudi Arabia: a retrospective study. Annals of Saudi Medicine. 2020; 40:425-435 https://doi.org/10.5144/0256-4947.2020.425

Joret MO, Dean A, Cao C The financial burden of surgical and endovascular treatment of diabetic foot wounds. Journal of Vascular Surgery. 2016; 64:648-655 https://doi.org/10.1016/j.jvs.2016.03.421

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Azzopardi K, Gatt A, Chockalingam N Hidden dangers revealed by misdiagnosed diabetic neuropathy: A comparison of simple clinical tests for the screening of vibration perception threshold at primary care level. Primary Care Diabetes. 2018; 12:111-115 https://doi.org/10.1016/j.pcd.2017.09.004

Armstrong DG, Lavery LA, Vela SA Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. Archives of Internal Medicine. 1998; 158:289-292 https://doi.org/10.1001/archinte.158.3.289

Hu A, Koh B, Teo M-R. A review of the current evidence on the sensitivity and specificity of the Ipswich touch test for the screening of loss of protective sensation in patients with diabetes mellitus. Diabetology International. 2021; 12:145-150 https://doi.org/10.1007/s13340-020-00451-9

Dutta A, Rastogi A, Jude EB. Screening developments for the foot in diabetes. The Diabetic Foot Journal. 2020; 23:(2)62-69

Arnold JF. Vascular assessment of the lower extremity with a chronic wound. The Surgical Clinics of North America. 2020; 100:807-822 https://doi.org/10.1016/j.suc.2020.05.008

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Álvaro-Afonso FJ, García-Morales E, Molines-Barroso RJ Interobserver reliability of the ankle-brachial index, toe-brachial index and distal pulse palpation in patients with diabetes. Diabetes & Vascular Disease Research. 2018; 15:344-347 https://doi.org/10.1177/1479164118767599

Ming A, Walter I, Alhajjar A Study protocol for a randomized controlled trial to test for preventive effects of diabetic foot ulceration by telemedicine that includes sensor-equipped insoles combined with photo documentation. Trials. 2019; 20 https://doi.org/10.1186/s13063-019-3623-x

Crawford F, Cezard G, Chappell FM. The development and validation of a multivariable prognostic model to predict foot ulceration in diabetes using a systematic review and individual patient data meta-analyses. Diabetic Medicine. 2018; 35:1480-1493 https://doi.org/10.1111/dme.13797

Soukup T, Lamb BW, Arora S Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. Journal of Multidisciplinary Healthcare. 2018; 11:49-61 https://doi.org/10.2147/jmdh.S117945

Taberna M, Gil Moncayo F, Jané-Salas E The multidisciplinary team (MDT) approach and quality of care. Front Oncol. 2020; 10:85-85 https://doi.org/10.3389/fonc.2020.00085

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Musuuza J, Sutherland BL, Kurter S A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. Journal of Vascular Surgery. 2020; 71:1433-1446 https://doi.org/10.1016/j.jvs.2019.08.244

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Hinchliffe RJ, Forsythe RO, Apelqvist J Guide-lines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020; 36 https://doi.org/10.1002/dmrr.3276

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Diabetic foot ulcers: treatment overview and cost considerations

02 December 2022
Volume 6 · Issue 4

Diabetic foot ulcers (DFUs) are deep tissue lesions associated with ischaemic, neuropathic, or combined neuroischaemic abnormalities and are a leading cause of morbidity and mortality.1,2 Of concern is that DFUs affect multiple areas of a person’s functioning, including both physical and psychological distress.3,4 For example, inactivity due to a DFU can cause feelings of frustration, anger and guilt in patients.5,6 This distress has the potential to impair the immune response as well as impacting the quality of life (QoL).7,8,9

DFUs are often complicated by the presence of infection and this combined with abnormalities are a key cause of amputation in patients with DM, indeed up to 85% of lower extremity amputations are preceded by the presence of a DFU.10 Furthermore, even when treatment plans are followed, not all DFUs heal, and those that do have a high rate of recurrence.11,12

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