Diagnosis, Prognosis and Treatment of Peripheral Vascular Disease in Patients with Diabetic Foot Ulcer: Adopted IWGDF Guidance

Peripheral arterial disease (PAD) is common in diabetic patients, and about half of the patients with diabetic foot ulcers (DFU) have concomitant peripheral arterial disease (PAD). The purpose of this study was to select an appropriate and comprehensive clinical guide in the management of DFU. The part of the practical guide that pertains to this is based on three systematic reviews in three sections of diagnosis, prognosis, and treatment for DFU in patients with PAD.

In this study, the ADAPTE methodology process consiss of the three stages of preparation, acceptance or final adoption and finalization for the localization of an international clinical guide.

Results are presented in the form of questions and recommendations in three sections, i.e. diagnosis, 2 questions and 3 recommendations, diagnosis  prognosis and treatment. In the diagnosis section, and in the prognosis section (2 questions and 6 recommendations), and in the treatment section (3 questions and 8 recommendations).

In this practical guide, our take home massage, i.e. what we should learn and practice is summarized as follows:  1) We examine a patient with diabetes for peripheral arterial disease yearly. 2) Despite the best possible treatment in patients with DFU, if the wound does not improve after six weeks, we should refer the patient to a vascular surgeon. 3) Patients with PAD, associated with foot infections are at high risk for extreme amputation of the lower limbs and need urgent interventions. 4) All patients with diabetes with ischemic DFU should receive appropriate therapeutic treatment, similar to that for cardiovascular patients.