These guidelines are based upon two companion International Working Group on the Diabetic foot papers: ‘A Systematic Review of the Effectiveness of Revascularisation of the Ulcerated Foot in Patients with Diabetes and Peripheral Arterial Disease’ and ‘Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report’. Peripheral arterial disease (PAD) is an important predictor of outcome of ulceration of the foot in patients with diabetes. The clinician examining a patient with diabetes and an ulcer of the foot should therefore always evaluate the vascular status of the lower extremity, specifically looking for signs of ischaemia, as up to 50% of these patients have PAD. Before a major amputation is undertaken, revascularization should always be considered and discussed preferably in a multidisciplinary diabetic foot team. None declared.
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Schaper et al. (2012) studied this question.