The Foot in Diabetes 4th Edition by Andrew James Michael Boulton, Gerry Rayman ISBN 0470029366 9780470029367

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ISBN 10: 0470029366 
ISBN 13: 9780470029367
Author: Andrew James Michael Boulton, Gerry Rayman

Since the publication of the third edition of The Foot in Diabetes, there have been important developments in the field of diabetic foot care and its scientific basis, including: The introduction of new technologies such as vacuum therapy, new casting techniques, the use of hormones and growth factors in wound healing; Advances in the understanding of the biomechanics of foot problems; Increased problems with multidrug-resistant organisms; The introduction of new international guidelines for the management of foot infections; Significant progress in the use of cytokines, metalloproteinase inhibitors, stem cells and gene therapy in wound healing. This fourth edition of this popular title maintains the strengths of earlier editions, with a strong emphasis on practical applications and management. All the chapters have been fully revised and updated, with new chapters introduced to cover the topics listed above. This book features more international contributors, giving it more global relevance than before, and for the first time it includes colour plates. With its focus on practically oriented advice, this book is essential reading for all members of the diabetes specialist team including diabetologists, podiatrists, specialist nurses, general practitioners, surgeons and clinical researchers. 

The Foot in Diabetes 4th Table of contents:

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1 Epidemiology and Economic Impact of Foot Ulcers
1.1 Introduction
1.2 Diabetic Foot Ulcer (DFU) Definition
1.3 DFU Classification
1.4 DFU Incidence and Prevalence
1.5 DFU Recurrence
1.6 Risk Factors for Diabetic Foot Ulcers and Lower Extremity Amputation
1.7 Diabetic Foot Ulcer Outcomes
1.8 Economic Considerations
References

2 Cost of Diabetic Foot Disease in England
2.1 Introduction
2.2 Human Costs
2.3 Financial Costs
2.4 Why Measure Costs?
2.5 Establishing Healthcare Priorities
2.6 Conclusions
References

3 Epidemiology of Amputation and the Influence of Ethnicity
3.1 Why Study the Epidemiology of LEA?
3.2 LEA Incidence Study Design: The Risk of Bias
3.3 LEA Risk Assessment Study Design
3.4 Risk Factors for LEA
3.5 Incidence Rates of LEA
3.6 International and Regional Differences
3.7 Time Trends in LEA Rates
3.8 Ethnic Differences in Diabetes‐Related LEA
3.9 Ethnic Differences in Diabetes‐Related LEA Risk
3.10 Indian Asians
References

4a The Diabetic Foot Worldwide: India
4a.1 Introduction
4a.2 Epidemiology of Diabetes in India
4a.3 Socio Economic Burden Due to Diabetes
4a.4 Common Risk Factors for Amputation in India
4a.5 Diagnosing High Risk Feet in Developing Countries
4a.6 Comparison in Risk Factors between India and the Western World
4a.7 DFI as a Cause for Declining Kidney Function
4a.8 Helping People with Amputation Cope Up with the Disability
References

4b The Diabetic Foot Worldwide: Pakistan
4b.1 Introduction
4b.2 Concept of Multidisciplinary Diabetic Foot Care Team (MDFCT)
4b.3 Nationwide Diabetic Foot Programme (Step by Step‐[SbS])
4b.4 Footwear for Every Diabetic (FED)
4b.5 Further Steps Ahead of SbS
References

4c The Diabetic Foot Worldwide: Sub‐Saharan Africa
4c.1 Introduction
4c.2 Pathophysiology of Foot Ulcers
4c.3 Peripheral Neuropathy (PN)
4c.4 Peripheral Arterial Diseases (PAD)
4c.5 Foot Ulceration in SSA
4c.6 Foot Infection
4c.7 Amputation
4c.8 Mortality
4c.9 Prevention
4c.10 Conclusions
References

4d Burden of Diabetic Foot Disease in Brazil
References

4e Diabetic Foot in Romania and Eastern Europe
4e.1 Introduction
4e.2 The Aim
4e.3 Diabetic Foot in Romania
4e.4 Diabetic Foot in Eastern Europe
4e.5 Conclusions
References

4f Diabetic Foot Worldwide: Pacific Region
References

4g The Diabetic Foot Worldwide: Middle East
4g.1 The Burden of Diabetic Foot Disease (DFD) in the Middle East (ME)
4g.2 Specific Regional Barriers to Healthy Feet and Foot Care
4g.3 Misconceptions
4g.4 Footwear
4g.5 Foot Care, Education and Awareness
References

4h The Diabetic Foot Worldwide: Australasia
4h.1 Introduction
4h.2 Australia
4h.3 New Zealand
4h.4 Pacific Islands
4h.5 Conclusion
References

5 Diabetic Neuropathy
5.1 Epidemiology
5.2 Classification
5.3 Symmetrical Neuropathies
5.4 Asymmetrical Neuropathies
5.5 Pathogenesis of Distal Symmetrical Neuropathy
5.6 Management of Diabetic Neuropathy
References

6 The Pathway to Ulceration
6.1 Introduction
6.2 Peripheral Arterial Disease (PAD)
6.3 Diabetic Neuropathy
6.4 Neuropathy: The Major Contributory Factor in Ulceration
6.5 Other Risk Factors for Foot Ulceration
6.6 Assessment of Foot Ulcer Risk
6.7 The Pathway to Ulceration
6.8 Mechanical Factors and Neuropathic Foot Ulceration
6.9 The Patient with Sensory Loss
References

7 Biomechanics of the Diabetic Foot for the Uninitiated
7.1 Introduction
7.2 The Concept of Pressure and its Measurement
7.3 The Role of Elevated Plantar Pressure in Foot Ulceration
7.4 Mechanisms of Elevated Plantar Pressure
7.5 Foot Biomechanics in Treating a Plantar Foot Ulcer
7.6 Biomechanical Issues in Preventing a Foot Ulcer
7.7 Summary
Acknowledgement
References

8 Psychological and Behavioural Aspects of Diabetic Foot Ulceration
8.1 The Role of Psychological and Behavioural Factors in DFU Development
8.2 The Role of Psychological and Behavioural Factors in DFU Healing
8.3 The Impact of DFUs on Patients’ Health Status and QoL
8.4 Measuring QoL in DFU Patients: Generic, DFU‐Specific or Combined Approach?
Acknowledgement
References

9 What Role for the Plain Radiograph of the Diabetic Foot?
9.1 Introduction
9.2 Pathologies
9.3 Summary
References

10 Advanced Cross‐Sectional Radiology‐Ultrasound, Computed Tomography and Magnetic Resonance Imaging of the Diabetic Foot
10.1 Introduction
10.2 Pathophysiology of Diabetic Foot Disease
Disclosures
References

11 Gait and Exercise Training in Diabetic Peripheral Neuropathy
11.1 Introduction
11.2 Gait Characteristics of People with Diabetes
11.3 Muscle Forces and the Biomechanics of Gait in Diabetes
11.4 Biomechanical Strategies to Alter Gait in Diabetic Peripheral Neuropathy
11.5 Falls and Diabetic Peripheral Neuropathy
11.6 Biomechanical Factors Leading to Increased Fall Risk
11.7 Diabetic Peripheral Neuropathy and Balance during Gait
11.8 Exercise and Diabetic Peripheral Neuropathy
11.9 Effects of Exercise in Patients with Diabetic Peripheral Neuropathy on Gait and Balance
11.10 The Case for Resistance Exercise Training
References

12 Smart Technology for the Diabetic Foot in Remission
12.1 Background
12.2 Technologies to Guide the Prescription of Footwear‐Related Offloading Treatments
12.3 Technologies to Facilitate Triaging those at High Risk of DFU
12.4 Technologies to Manage Dose of Physical Activities in People with Diabetes and Insensate Foot
12.5 Using Technology to Improve Patient Education for Effective Prevention of Diabetic Foot Ulcers
12.6 Mobile Health (mHealth) to Manage Diabetic Foot Ulcers
12.7 Internet of Things and Remote Management of Diabetic Foot Ulcers
12.8 Technologies to Facilitate Delivering of Therapy at Home and Reduce Risk of DFU
12.9 Conclusion
References

13 How to Assess the Quality of Clinical Trials for Diabetic Foot Ulcer Therapies
13.1 Introduction
13.2 Hierarchy of Evidence
13.3 Items to Be Considered in Assessing Trials of Diabetic Foot Ulcer Therapies
13.4 The Population
13.5 The Person and Limb
13.6 The Ulcer
13.7 The Therapy
13.8 Outcomes
13.9 Adverse Events
13.10 21 Point Checklist
References

14a Bypass in Diabetic Peripheral Artery Disease
14a.1 Identifying Significant PAD Amongst Patients Presenting with Foot Ulcers
14a.2 Relative Benefits and Risks: Identifying Patients Who May Benefit from a Leg Bypass Operation
14a.3 Evaluating Relevant Vascular Anatomy for Planning a Bypass Operation
14a.4 The Operation and Early In‐Hospital Recovery
14a.5 Follow‐Up After a Leg Bypass Operation
References

14b Surgery or Endovascular Intervention in Diabetic Peripheral Vascular Disease
14b.1 Introduction
14b.2 Background
14b.3 Diagnosis
14b.4 Management
14b.5 Endovascular Revascularization
14b.6 Results
14b.7 Complications
14b.8 Conclusion
References

15 Inpatient Diabetic Foot Care
15.1 Introduction
15.2 The Burden of Inpatient Diabetes
15.3 The Burden of Inpatient Diabetic Foot Disease
15.4 Recommended Foot Care for Inpatients with Diabetes
15.5 Summary
Disclosures
References

16 Diagnosis and Management of Infection in the Diabetic Foot
16.1 Introduction
16.2 Pathophysiology of Infections in Persons with Diabetes Mellitus
16.3 Risk Factors for DFI
16.4 Clinical Signs and Symptoms
16.5 Classification
16.6 Microbiology
16.7 Treatment
16.8 IWGDF Grade 4 (Severe) Infections
16.9 Osteomyelitis
References

17 Surgical Approach to Diabetic Foot Infections
17.1 Introduction
17.2 Initial Evaluation
17.3 Initial Surgical Intervention
17.4 After Initial Surgical Intervention
17.5 Staged Surgical Intervention and Wound Closure
17.6 Surgical Offloading
17.7 Soft Tissue/Tendon Balancing and Definitive Osseous Surgical Reconstruction
17.8 Decision for Proximal Level Amputation
17.9 Conclusions
References

18 The Evidence Base for the Choice of Dressings in the Management of Diabetic Foot Ulcers
18.1 The Problems
18.2 Quality of Evidence
18.3 The Definition of a Dressing
18.4 The Roles of the Dressing
18.5 Basic Aspects of Wound Care
18.6 Evidence for Potential Contributions of Dressings and Wound Applications to Improve Wound Healing
18.7 Other Therapies which May Modulate Healing of Chronic Wounds
18.8 Summary
Conflicts of Interest
References

19 Pathogenesis of Charcot Neuroarthropathy and Acute Management
19.1 Introduction
19.2 Pathogenesis of CN
19.3 Acute Management of CN
19.4 Conclusions
References

20 Surgical Reconstruction of the Charcot Foot
20.1 Introduction
20.2 Indications for Surgical Reconstruction
20.3 Radiographic Predictors for Ulceration
20.4 Timing of Surgery
20.5 Preoperative Medical Workup
20.6 Glycemic Control
20.7 Vitamin D
20.8 Renal Function
20.9 Procedures/Outcome Studies
20.10 Outcomes of Charcot Reconstruction
20.11 Summary of Evidence Based Recommendations
References

21 Amputation in the Diabetic Foot
21.1 Introduction
21.2 Impediments to Rehabilitation in the Diabetic Amputee
21.3 The Lower Extremity as an Organ of Weight Bearing
21.4 Metabolic Cost of Walking with an Amputation
21.5 Limb Salvage vs. Amputation
21.6 Amputation Level Selection
21.7 The Terminal Organ of Weight Bearing
21.8 The Soft Tissue Envelope
21.9 Tissue Management
21.10 Outcomes Following Amputation
21.11 Surgical Amputation Levels
21.12 Lesser Toe Amputation
21.13 Ray Resection
21.14 Midfoot Amputation
21.15 Hindfoot Amputation
21.16 Symes’s Ankle Disarticulation Amputation
21.17 Transtibial Amputation
21.18 Knee Disarticulation Amputation
21.19 Transfemoral Amputation
21.20 Conclusions
References

22 Rehabilitation of the Amputee
22.1 Lower Limb Amputation and Prosthetics
22.2 Foot Amputations
22.3 Foot Orthotics
22.4 Transtibial Amputations
22.5 Ankle/Foot Components
22.6 Conclusion
References

23 Surgery for the Diabetic Foot
23.1 The Role of Surgery Preventing Occurrence and Recurrence of Foot Ulcers
23.2 Preoperative Care
23.3 Hallux and First Metatarsal Head Procedures
23.4 Lesser Toes
23.5 Lesser Metatarsal Heads
23.6 Tendon Achilles Lengthening
23.7 Curative Surgery for Treating Diabetic Foot Osteomyelitis
23.8 Surgery of Forefoot Osteomyelitis
23.9 Surgery of Midfoot Osteomyelitis
23.10 Surgery of Rear Foot Osteomyelitis
References

24 Footwear and Orthoses for People with Diabetes
24.1 Introduction
24.2 What is a Therapeutic Shoe for a Person Living with Diabetes?
24.3 Who Needs Therapeutic Shoes?
24.4 Choosing the Appropriate Footwear for the Patient with LOPS
24.5 Summary and Future Trends
Acknowledgement
Conflict of Interest Statement
References

25 The Diabetic Foot in Remission
25.1 The Diabetic Foot in Remission
25.2 Maintaining Remission
25.3 Conclusion
References

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