Interpretation of 2019 International Working Group on Diabetic Foot guidelines on the prevention and management of diabetic foot disease_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Lei ,  WANG Jiangning , YIN Yefeng

Department of Orthopaedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, P.R.China;

Corresponding author：

WANG Jiangning, Email: dlwangjn@vip.sina.com

Keywords：

International Working Group on Diabetic Foot; diabetic foot; prevention; treatment; guideline

DOI：

10.7507/1002-1892.201906014

Video：

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The 8th World International Symposium on the Diabetic Foot (ISDF) Conference which was sponsored by the International Working Group on Diabetic Foot (IWGDF) was held in the Hague between May 22nd and May 25th, 2019. The conference issued the 2019 IWGDF guidelines on the prevention and management of diabetic foot disease. The update to the 2015 edition of the guidelines involves the following 6 chapters: prevention of foot ulcers in patients with diabetes; offloading foot ulcers in patients with diabetes; diagnosis, prognosis, and management of peripheral arterial disease in patients with a foot ulcer and diabetes; diagnosis and treatment of foot infection in patients with diabetes; interventions to enhance healing of foot ulcers in patients with diabetes; classification of diabetic foot ulcers. This guideline has been changed more than the previous edition. In this paper, the guidelines will be interpreted to provide cutting-edge information for domestic diabetic foot researchers.

Citation： GAO Lei, WANG Jiangning, YIN Yefeng. Interpretation of 2019 International Working Group on Diabetic Foot guidelines on the prevention and management of diabetic foot disease. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(1): 16-20. doi: 10.7507/1002-1892.201906014 Copy

1.	Bus SA, van Netten JJ, Lavery LA, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 16-24.
2.	Coffey L, Mahon C, Gallagher P. Perceptions and experiences of diabetic foot ulceration and foot care in people with diabetes: A qualitative meta-synthesis. Int Wound J, 2019, 16(1): 183-210.
3.	Keukenkamp R, Merkx MJ, Busch-Westbroek TE, et al. An explorative study on the efficacy and feasibility of the use of motivational interviewing to improve footwear adherence in persons with diabetes at high risk for foot ulceration. J Am Podiatr Med Assoc, 2018, 108(2): 90-99.
4.	Jeffcoate WJ, Vileikyte L, Boyko EJ, et al. Current challenges and opportunities in the prevention and management of diabetic foot ulcers. Diabetes Care, 2018, 41(4): 645-652.
5.	Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med, 2017, 376(24): 2367-2375.
6.	Bus SA. The role of pressure offloading on diabetic foot ulcer healing and prevention of recurrence. Plast Reconstr Surg, 2016, 138(3 Suppl): 179S-187S.
7.	王江宁, 高磊. 糖尿病足慢性创面治疗的新进展. 中国修复重建外科杂志, 2018, 32(7): 832-837.
8.	Randhawa MS, Reed GW, Grafmiller K, et al. Prevalence of tibial artery and pedal arch patency by angiography in patients with critical limb ischemia and noncompressible ankle brachial index. Circ Cardiovasc Interv, 2017, 10(5): pii: e004605.
9.	Rigato M, Pizzol D, Tiago A, et al. Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa. A systemic review and meta-analysis. Diabetes Res Clin Pract, 2018, 142: 63-73.
10.	Mills JL Sr, Conte MS, Armstrong DG, et al. The society for vascular surgery lower extremity threatened limb classification system: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg, 2014, 59(1): 220-234.
11.	Weaver ML, Hicks CW, Canner JK, et al. The society for vascular surgery wound, ischemia, and foot infection (WIfI) classification system predicts wound healing better than direct angiosome perfusion in diabetic foot wounds. J Vasc Surg, 2018, 68(5): 1473-1481.
12.	Ali SR, Ozdemir BA, Hinchliffe RJ. Critical appraisal of the quality of evidence addressing the diagnosis, prognosis, and management of peripheral artery disease in patients with diabetic foot ulceration. Eur J Vasc Endovasc Surg, 2018, 56(3): 401-408.
13.	Lipsky BA, Aragón-Sánchez J, Diggle M, et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 45-74.
14.	Peters EJ, Lipsky BA, Aragón-Sánchez J, et al. Interventions in the management of infection in the foot in diabetes: a systematic review. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 145-153.
15.	Uckay I, Jornayvaz FR, Lebowitz D, et al. An overview on diabetic foot infections, including issues related to associated pain, hyperglycemia and limb ischemia. Curr Pharm Des, 2018, 24(12): 1243-1254.
16.	Morozova VV, Kozlova YN, Ganichev DA, et al. Bacteriophage treatment of infected diabetic foot ulcers. Methods Mol Biol, 2018, 1693: 151-158.
17.	Fish R, Kutter E, Wheat G, et al. Compassionate use of bacteriophage therapy for foot ulcer treatment as an effective step for moving toward clinical trials. Methods Mol Biol, 2018, 1693: 159-170.
18.	Ndosi M, Wright-Hughes A, Brown S, et al. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study. Diabet Med, 2018, 35(1): 78-88.
19.	Zha ML, Cai JY, Chen HL. A bibliometric analysis of global research production pertaining to diabetic foot ulcers in the past ten years. J Foot Ankle Surg, 2019, 58(2): 253-259.
20.	李雪梅, 张雨诗, 钟科, 等. 改良型富血小板纤维蛋白与 β-磷酸三钙复合物诱导骨再生的研究. 中国修复重建外科杂志, 2019, 33(2): 177-184.
21.	吕洋, 王江宁. 富血小板血液制品在组织创伤愈合中的应用进展. 中华医学美学美容杂志, 2018, 24(3): 159-161.
22.	Miron RJ, Fujioka-Kobayashi M, Hernandez M, et al. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig, 2017, 21(8): 2619-2627.
23.	Balse N, Baliga S. " Evaluation of wound healing and bone regeneration using autologous platelet-rich plasma and platelet-rich fibrin postextractions”: A comparative study. Indian Journal of Health Sciences and Biomedical Research (KLEU), 2017, 10(2): 167-172.
24.	Battiston B, Ciclamini D, Tang JB. Compound or specially designed flaps in the lower extremities. Clin Plast Surg, 2017, 44(2): 287-297.
25.	王寿宇, 吕德成, 王媛媛, 等. 蛆虫分泌物对糖尿病大鼠溃疡组织 bFGF 和结缔组织生长因子表达的影响及抗菌作用研究. 中国修复重建外科杂志, 2008, 22(4): 472-475.
26.	高磊, 李天博, 刘燕玲, 等. 皮肤牵张闭合器在难愈性褥疮创面修复中的应用. 中华显微外科杂志, 2018, 41(1): 80-83.
27.	高磊, 王硕, 王雷, 等. 皮肤牵张闭合器在糖尿病足创面修复中的应用. 中国修复重建外科杂志, 2018, 32(5): 591-595.
28.	Game F. Classification of diabetic foot ulcers. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 186-194.
29.	Jeon BJ, Choi HJ, Kang JS, et al. Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation. Int Wound J, 2017, 14(3): 537-545.

1. Bus SA, van Netten JJ, Lavery LA, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 16-24.
2. Coffey L, Mahon C, Gallagher P. Perceptions and experiences of diabetic foot ulceration and foot care in people with diabetes: A qualitative meta-synthesis. Int Wound J, 2019, 16(1): 183-210.
3. Keukenkamp R, Merkx MJ, Busch-Westbroek TE, et al. An explorative study on the efficacy and feasibility of the use of motivational interviewing to improve footwear adherence in persons with diabetes at high risk for foot ulceration. J Am Podiatr Med Assoc, 2018, 108(2): 90-99.
4. Jeffcoate WJ, Vileikyte L, Boyko EJ, et al. Current challenges and opportunities in the prevention and management of diabetic foot ulcers. Diabetes Care, 2018, 41(4): 645-652.
5. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med, 2017, 376(24): 2367-2375.
6. Bus SA. The role of pressure offloading on diabetic foot ulcer healing and prevention of recurrence. Plast Reconstr Surg, 2016, 138(3 Suppl): 179S-187S.
7. 王江宁, 高磊. 糖尿病足慢性创面治疗的新进展. 中国修复重建外科杂志, 2018, 32(7): 832-837.
8. Randhawa MS, Reed GW, Grafmiller K, et al. Prevalence of tibial artery and pedal arch patency by angiography in patients with critical limb ischemia and noncompressible ankle brachial index. Circ Cardiovasc Interv, 2017, 10(5): pii: e004605.
9. Rigato M, Pizzol D, Tiago A, et al. Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa. A systemic review and meta-analysis. Diabetes Res Clin Pract, 2018, 142: 63-73.
10. Mills JL Sr, Conte MS, Armstrong DG, et al. The society for vascular surgery lower extremity threatened limb classification system: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg, 2014, 59(1): 220-234.
11. Weaver ML, Hicks CW, Canner JK, et al. The society for vascular surgery wound, ischemia, and foot infection (WIfI) classification system predicts wound healing better than direct angiosome perfusion in diabetic foot wounds. J Vasc Surg, 2018, 68(5): 1473-1481.
12. Ali SR, Ozdemir BA, Hinchliffe RJ. Critical appraisal of the quality of evidence addressing the diagnosis, prognosis, and management of peripheral artery disease in patients with diabetic foot ulceration. Eur J Vasc Endovasc Surg, 2018, 56(3): 401-408.
13. Lipsky BA, Aragón-Sánchez J, Diggle M, et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 45-74.
14. Peters EJ, Lipsky BA, Aragón-Sánchez J, et al. Interventions in the management of infection in the foot in diabetes: a systematic review. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 145-153.
15. Uckay I, Jornayvaz FR, Lebowitz D, et al. An overview on diabetic foot infections, including issues related to associated pain, hyperglycemia and limb ischemia. Curr Pharm Des, 2018, 24(12): 1243-1254.
16. Morozova VV, Kozlova YN, Ganichev DA, et al. Bacteriophage treatment of infected diabetic foot ulcers. Methods Mol Biol, 2018, 1693: 151-158.
17. Fish R, Kutter E, Wheat G, et al. Compassionate use of bacteriophage therapy for foot ulcer treatment as an effective step for moving toward clinical trials. Methods Mol Biol, 2018, 1693: 159-170.
18. Ndosi M, Wright-Hughes A, Brown S, et al. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study. Diabet Med, 2018, 35(1): 78-88.
19. Zha ML, Cai JY, Chen HL. A bibliometric analysis of global research production pertaining to diabetic foot ulcers in the past ten years. J Foot Ankle Surg, 2019, 58(2): 253-259.
20. 李雪梅, 张雨诗, 钟科, 等. 改良型富血小板纤维蛋白与 β-磷酸三钙复合物诱导骨再生的研究. 中国修复重建外科杂志, 2019, 33(2): 177-184.
21. 吕洋, 王江宁. 富血小板血液制品在组织创伤愈合中的应用进展. 中华医学美学美容杂志, 2018, 24(3): 159-161.
22. Miron RJ, Fujioka-Kobayashi M, Hernandez M, et al. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig, 2017, 21(8): 2619-2627.
23. Balse N, Baliga S. " Evaluation of wound healing and bone regeneration using autologous platelet-rich plasma and platelet-rich fibrin postextractions”: A comparative study. Indian Journal of Health Sciences and Biomedical Research (KLEU), 2017, 10(2): 167-172.
24. Battiston B, Ciclamini D, Tang JB. Compound or specially designed flaps in the lower extremities. Clin Plast Surg, 2017, 44(2): 287-297.
25. 王寿宇, 吕德成, 王媛媛, 等. 蛆虫分泌物对糖尿病大鼠溃疡组织 bFGF 和结缔组织生长因子表达的影响及抗菌作用研究. 中国修复重建外科杂志, 2008, 22(4): 472-475.
26. 高磊, 李天博, 刘燕玲, 等. 皮肤牵张闭合器在难愈性褥疮创面修复中的应用. 中华显微外科杂志, 2018, 41(1): 80-83.
27. 高磊, 王硕, 王雷, 等. 皮肤牵张闭合器在糖尿病足创面修复中的应用. 中国修复重建外科杂志, 2018, 32(5): 591-595.
28. Game F. Classification of diabetic foot ulcers. Diabetes Metab Res Rev, 2016, 32(Suppl 1): 186-194.
29. Jeon BJ, Choi HJ, Kang JS, et al. Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation. Int Wound J, 2017, 14(3): 537-545.

Chinese Journal of Reparative and Reconstructive Surgery

Interpretation of 2019 International Working Group on Diabetic Foot guidelines on the prevention and management of diabetic foot disease

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