Standard, Appropriate, and Advanced Care and Medical-Legal Considerations: Part One -- Diabetic Foot Ulcerations

Gerit Mulder, DPM, MS, David Armstrong, DPM, Susie Seaman, MSN, NP, CETN


Wounds. 2003;15(4) 

In This Article


Cost containment, managed healthcare, and capitated systems often consider unit cost of treatments while neglecting the overall cost associated with long-term treatments resulting from complications arising from inappropriate care of an ulcer, particularly in the diabetic population. Standard care may be the accepted care in the medical community, but it may not be appropriate care. Advanced treatment modalities are appropriate and need to become part of standard care in the high-risk population with chronic ulcers. Standard care guidelines may no longer be considered the sole determinant of what may be appropriate for all ulcers, particularly diabetic ulcers, treated by the healthcare provider in the community. The treatment ultimately selected for each patient may have a significant impact on results. Considering each patient's individual living environment, compliance, ability to self administer care, socioeconomic status and ability to purchase or obtain prescribed products, ambulatory status, wound status, and overall medical history will assist with selection of the most appropriate treatment modality and continuum of care. The healthcare provider has a duty to provide appropriate medical care whenever possible. This manuscript has provided a general overview of factors to consider when caring for the diabetic foot ulcer.


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