The care of lower extremity lesions in patients with diabetes

Persons with diabetes, because of compromised circulation and sensation, are highly susceptible to slow-healing lesions of the lower extremities. Diabetic foot lesions often begin with a minor trauma and end in amputation; however, proper management of these lesions can avoid this progression. The major principles of foot lesion management include optimizing blood glucose control, controlling sepsis, debriding necrotic tissue, using appropriate dressings, treating local edema, restricting ambulation, wearing protective footwear, and educating patients in proper footcare. This article discusses these principles and gives specific recommendations for primary care practice.