Originally Posted by suresh
60 year old diabetic patient for 2 years duration,
Peripheral vascular disease? Other chronic complications? What kind of resources do you have available: drugs, human resources and orthotic supplies? What about patient's shoes?
As a general rule following the International Working Group on the diabetic foot
practical guidelines, I would say (if there are not further chronic diabetes complications):
1. Glycemic management
2. Patient Education
3. Wound care: cleaning and dressings
But, I would need to know more about your resources for giving you a consistent advice.
It seems there is not infection, right? If the patient have been able to avoid infection by his own for 2 years and his condition it has not gotten worse, I am confident his heel ulcers can be heeled.
Also, you can download the Diabetic Foot Disorders Clinical Practice Guideline
from ACFAS link here
. It is a pretty good practice guideline.