How is ulceration examined in the evaluation of diabetic foot ulcers?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Accomplish the following in examination of ulceration

  • Determine the location of the ulceration, as ulcers are typically located around bony prominences and weight-bearing surfaces; typical locations include the dorsal interphalangeal joints of hammertoes and distal tips of digits, below metatarsal heads in claw toes, the medial and lateral forefoot in patients with bunions and bunionettes, plantar lateral wounds in Charcot foot, and the lateral foot and lateral malleoli in varus deformities
  • Measure the size, including the depth of the wound
  • Describe the wound base (granular, fibrotic, necrotic, eschar)
  • Inspect for probing to bone
  • Inspect for any undermining or tunneling of the wound
  • Describe any drainage
  • Describe the periwound area (maceration, hyperkeratotic tissue)

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