Wound Management and the Utility of Adjunctive Technologies in Diabetic Limb Salvage

Abstract

As the projected prevalence of diabetes worldwide advances, the need for comprehensive treatments becomes paramount. Diabetes is estimated to afflict over 430 million people by the year 2030. It is without question that complications associated with poorly managed diabetes become a threat to the limbs and lives of this cohort. A targeted, specific, and comprehensive algorithm toward the management of lower extremity pathology related to diabetes is an essential public health endeavor. This review is aimed at addressing three key areas: surgical and adjunctive management options for diabetic lower extremity ulcerations, the challenges of lower extremity salvage, and to provide an introduction to the utility of advanced wound management technologies. An emphasis directed at understanding risks and benefits of each modality is discussed. An analysis of available biologic allografts and skin substitutes will be provided in the context of our working knowledge in regenerative medicine and wound treatments. This review has 5 figures and 45 references Key Words: amputation, biologics, debridement, diabetes, infection, , limb salvage, negative pressure wound therapy, peripheral arterial disease, , ulcer