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Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

Authors Kanapathy M, Portou M, Tsui J, Richards T

Received 29 March 2015

Accepted for publication 4 June 2015

Published 19 August 2015 Volume 2015:2 Pages 129—136

DOI https://doi.org/10.2147/CWCMR.S62919

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Marco Romanelli


Muholan Kanapathy,1 Mark J Portou,1,2 Janice Tsui,1,2 Toby Richards1,2

1Division of Surgery and Interventional Science, University College London, 2Department of Vascular Surgery, Royal Free London NHS Foundation Trust Hospital, London, UK

Abstract: Diabetic foot ulcers (DFUs) are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.

Keywords: diabetic foot ulcer, lymphedema, chronic wound, wound management

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