Which of the following variables is not predictive of poor healing of diabetic foot ulcers?

Figure 26 shows the clinical photograph of a patient who has developed a residual limb ulcer following a traumatic transtibial amputation 2 years ago. What is the preferred treatment to resolve the ulcer?

Figure 26 shows the clinical photograph of a patient who has developed a residual limb ulcer following a traumatic transtibial amputation 2 years ago. What is the preferred treatment to resolve the ulcer?

A 62-year-old male with poorly controlled diabetes presents ...

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A 44-year-old male with long standing insulin dependent diabetes complains of a non-healing plantar foot ulcer. The ulcer is shown in Figure A. The second metatarsal head can be probed at the base of the wound, and he lacks plantar sensation. Laboratory work-up for infection is negative. Which of the following is the best initial treatment?

A 62-year-old woman is on follow-up with your office for rec...

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A 75-year-old diabetic man presents to clinic for evaluation...

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A 47-year-old female with uncontrolled diabetes mellitus and...

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A 55-year-old male with a history of poorly controlled diabetes presents to the Emergency Department with a chronic nonhealing foot ulcer depicted in Figure A. The patient is admitted to the hospital for glycemic control and wound care. Which of the following factors are prognostic for successful ulcer healing?

A 44-year-old man with diabetes mellitus has a non-healing Wagner grade 1 ulcer shown in Figure A for the past 8 months. Conservative management with total contact casting has not resolved the ulcer. Physical examination reveals loss of protective sensation by Semmes-Weinstein testing, no signs of infection, positive Silfverskiold test indicating gastrocnemius contracture, and palpable pedal pulses. What is the next most appropriate step in management?

A 52-year-old male with a longstanding history of type II di...

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A 66-year-old male with a known history of uncontrolled Type 2 diabetes presents for follow up of a forefoot ulcer that is seen in Figure A. All of the following are strong prognostic indicators of osteomyelitis EXCEPT:

A 60-year-old patient with a history of type 2 diabetes pres...

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A 65-year-old diabetic male presents with the foot ulcer shown in Figure A. There is no exposed bone, and no signs of infection. Pulses are palpable. What additional information should be obtained next to help guide this patient's treatment?

Figure A shows a clinical photograph of an ambulatory 55-yea...

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A 56-year-old male with uncontrolled diabetes presents for follow up of a recurrent midfoot ulceration. He has been placed into a total contact cast for extended periods without resolution of the ulcer. On physical examination the patient is unable to feel a 5.07 gm monofilament on the plantar aspect of his foot. He has an equinus contracture. A clinical photo of the patient and lateral radiograph of the foot are provided in Figures A & B. Radiographs are unchanged from prior evaluation. What is the next best option at this point?

A 45-year-old male presents to the ED via EMS following a roll-over MVC. He was intubated and placed into a cervical collar at the scene due to multiple injuries and combativeness on scene. Following stabilization in the emergency department, he is transferred to the ICU intubated and the cervical spine remains immobilized in a semi-rigid collar. For each day that cervical spine clearance is delayed, the risk of ulceration increases by what percentage?

A 55-year-old man is referred to you for management of a rec...

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A 70-year-old man is referred to your office for the neuropa...

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A 37-year-old man with type-1 diabetes mellitus reports a 3-month history of a plantar foot ulcer shown in Figure A. His pulses are palpable and sensation to a 5.07 Semmes-Weinstein monofilament is absent on the entire plantar surface of the foot. There is no erythema or drainage and there is no bone encountered during probing of the ulcer. There is no fever and the white blood cell count is normal. The C-reactive protein and erythrocyte sedimentation rate are normal. What is the most appropriate next step in treatment?

A 60-year-old woman with a long-standing history of diabetes...

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A 57-year-old man taking metformin for diabetes and gabapentin for peripheral neuropathy has a superficial plantar midfoot ulcer with a clean, noninfected appearance. Total contact casting is implemented for mechanical relief. Which of the following radiographs most likely corresponds to the clinical situation described?

A 35-year-old woman with type 1 diabetes mellitus has been t...

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A 64-year-old female with a long-standing history of periphe...

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A 45-year-old diabetic male has a Wagner type 3 heel ulcer shown in Figure A that measures 4x2cm and is recalcitrant to debridements and total contact casting for 4 months. The patient has palpable pulses, active drainage at the ulcer, and does not have protective sensation with a 5.07 Semmes-Weinstein filament. Radiograph and MRI (sagittal and axial) images are shown in Figures B-D respectively. In addition to bone culture biopsy, debridement and antibiotic therapy, what surgical intervention is most appropriate?

A 57-year-old man with type II diabetes mellitus was success...

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A 65-year-old man is referred to you for a heel ulcer that h...

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A 45-year-old man has a 6-month history of a leg mass and re...

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A 45-year-old woman with diabetic neuropathy is referred to your office for the Wagner grade 3 heel ulcer shown in Figure A. Her BMI is 42kg/m2. She is mostly homebound and rarely ventures outside the house. The dorsalis pedis pulse is palpable but the posterior tibial pulse is not. Both pulses are audible on Doppler ultrasound examination. She has had 3 previous ulcer debridements by a referring orthopedist. She has no constitutional symptoms and blood glucose levels and insulin requirements have not changed recently. Which treatment will maximize the chance of healing and minimize metabolic demand?