Pedal ulcers in older adults with diabetes mellitus

David R. Sinacore, Michael J. Mueller

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Diabetes mellitus and its complications increase with aging, which can make the management of pedal ulcers a difficult challenge for the rehabilitation and wound specialist. To prevent infections and subsequent lower extremity amputation, identification and healing of foot ulcers in older adults with diabetes should be a high priority for all rehabilitation and wound care specialists. This article reviews several potential impediments to pedal ulcer healing encountered in clinical practice for the older adult with diabetes mellitus. Therapeutic strategies to heal and prevent plantar foot ulcers are discussed, with particular emphasis on total-contact casting and other alternative off-loading strategies. Despite the often-held suspicion that wound healing is impaired in aging, this evidence suggests that healing time using total-contact casting is not impaired in older adults compared to younger adults with diabetes. Older adults with diabetes, however, appear to be at higher risk for developing plantar ulcers and potentially for wound failure because of the more frequent presence of accompanying peripheral vascular disease, foot deformity, and peripheral neuropathy.

Original languageEnglish
Pages (from-to)11-23
Number of pages13
JournalTopics in Geriatric Rehabilitation
Volume16
Issue number2
DOIs
StatePublished - Jan 1 2000

Keywords

  • Aging
  • Delayed wound healing
  • Diabetic complication
  • Foot ulcers
  • Total-contact casting

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