Management

All of these components of multidisciplinary management are important in stage 3:

• Mechanical control

• Wound control

• Vascular control

• Microbiological control

• Metabolic control

• Educational control.

The aim is to heal ulcers within the first 6 weeks of their development. This is the time for aggressive management and is a window of opportunity that should be taken seriously. All diabetic foot ulcers should be referred for multi-disciplinary care without delay so that the opportunity of early healing is not wasted. The ulcer is a pivotal event on the road to amputation, and the diabetic patient with an ulcer on the foot is at great risk of infection, gangrene and loss of the leg. Because it is difficult to predict which ulcers will do well and which will do catastrophically, it is essential to organize optimal care for all ulcers.

When ulcers are healed, the foot is treated as stage 2 to prevent recurrence.

Neuroischaemic ulcers may be painful and thus pain control will also be considered.

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