DFU Treatment Guide: The Three-Step Approach of Wound Care, Offloading, and Education

Overview of treatment approaches
(Treatment Overview)

The management of Diabetic Foot Ulcers (DFU) fundamentally includes three main treatment principles: wound care, offloading, and education1. Patients with diabetes, whether they have a DFU or not, should constantly prevent the occurrence or worsening of ulcerative wounds, especially those with risk factors. If ulcers symptoms are present, it is advised to seek medical attention promptly and consult healthcare professionals.

Here is a brief introduction to the general treatment principles for DFU patients from the "medical perspective"：

Wound Care for DFU

If a patient has an ulcerative wound on the foot, the first step is to assess the infection status. If there is no sign of infection, the focus of treatment should be on wound care to prevent the condition from worsening2. The International Working Group on the Diabetic Foot and the Infectious Diseases Society of America (IWGDF/IDSA) do not recommend the use of antibiotics as a preventative measure in patients without infections3.

However, healthcare providers should also notice and prevent the occurrence of ischemic symptoms of patient's wound and provide offloading treatment, debridement, or vascular reconstruction surgery as needed2.

So what exactly does the care and treatment of a DFU wound entail?

"Essentials of DFU Wound Care: Analysis of IWGDF Clinical Guidelines"

"Health on the Edge: Surgical Treatments for DFU"

Management of Infectious DFU

If an infection is present in the patient's ulcerative foot wound, the primary intervention is systemic antibiotic therapy, while considering the necessity of debridement surgery. If the wound exhibits both infection and ischemic symptoms, vascular reconstruction surgery or hospital treatment should be considered to avoid amputation or severe complications2.

Importance of Off-loading

Off-loading plays an extremely important role in both the treatment and prevention of DFU. Inappropriate plantar pressure not only increases the incidence and recurrence rates of ulcers but also, even in limbs with normal blood perfusion, if off-loading is not properly implemented, it can prolong the healing time of DFU wounds4.

Click here to learn more about off-loading related to foot care：

"The Power of Self-Care for Feet: Practical Tips for Preventing DFU"

Assistance from the Healthcare System and Long-Term Disease Prevention

Professionals within a robust healthcare system should provide patients with clear, practical, and proactive health education information, enabling patients to understand the importance of foot care and to motivate behavioral changes. This information has a positive effect on assisting patients in dealing with Diabetic Foot Ulcers (DFU)5.

In the long term, correct wound care methods and various preventive measures, including maintaining a good lifestyle, can not only prevent the worsening of DFU symptoms but also accelerate wound healing. Let us learn correctly and bravely face diabetic foot together!

Reference：
• Everett E et al. Ann N Y Acad Sci. 2018;1411(1):153-165.
• Armstrong DG et al. JAMA. 2023;330(1):62-75.
• Senneville É et al. Diabetes Metab Res Rev. 2023;e3687.
• Alexiadou K et al. Diabetes Ther. 2012;3(1):4.
• Coffey L et al. Int Wound J. 2019;16(1):183-210.