Assessment and management of diabetic foot ulcers

Diabetic foot ulcers can cause considerable disability and morbidity. The complex pathology requires expert and in-depth assessment and management to achieve the best outcomes. Assessment is underpinned by attention to four key points: vascular sufficiency, neurological/sensory status, appropriateness of footwear, and presence of foot deformity. The 'shopping list' for management is derived from the assessment and requires careful planning and a multidisciplinary approach. This article outlines key first line principles and practices in assessment and management of diabetic foot ulcers, including the importance of offloading pressure and mechanical trauma to aid healing and prevent recurrence.