Perfusion Assessment and Treatment in the Diabetic Patient

Clin Podiatr Med Surg. 2019 Jul;36(3):361-370. doi: 10.1016/j.cpm.2019.03.001.

Abstract

The accurate assessment of peripheral perfusion is a critical step in caring for a diabetic patient with active ulceration. This article guides the provider through diagnostic and therapeutic options. The perfusion assessment begins with a physical examination and augmented using noninvasive tests. Although some of these tests can be performed at the bedside, often a dedicated vascular laboratory is required. Additional cross-sectional imaging studies or formal angiography should be performed as well. These tools aid in the creation of the best therapeutic plan, which aims to restore perfusion and allow for rapid wound healing via open or endovascular means.

Keywords: Angiography; Endovascular; Noninvasive vascular studies; Perfusion; Surgical bypass.

Publication types

  • Review

MeSH terms

  • Ankle Brachial Index
  • Blood Circulation / physiology
  • Blood Pressure / physiology
  • Diabetes Mellitus / physiopathology*
  • Diabetic Foot / diagnostic imaging
  • Diabetic Foot / surgery*
  • Diagnostic Imaging
  • Endovascular Procedures
  • Foot / blood supply
  • Foot / diagnostic imaging
  • Humans
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / surgery*
  • Physical Examination
  • Pulse
  • Vascular Surgical Procedures