Abstract
The importance of the impact of neuropathy in the pathogenesis and management of the neuropathic foot is described. A pathway of limb salvage of the neuropathic foot is presented, summarising four important steps. Step 1 is debridement which removes the cellular burden of dead and senescent cells and also eliminates biofilm. Step 2 encompasses offloading which comprises some form of casting technique or cushioning insoles. Step 3 comprises advanced wound therapy including cell and tissue based products such as bioengineered cell-based therapies, acellular matrices, placental-derived membranes, recombinant growth factors, platelet rich plasma and matrix metalloproteinase inhibitors. Step 4 involves soft tissue coverage, ranging from split skin grafts,soft tissue advancement, local rotational flaps and free tissue transfer.
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Petrova, N.L., Sumpio, B.E., Edmonds, M.E. (2019). Introduction to the Neuropathic Foot: Limb Salvage Pathway and Algorithm. In: Edmonds, M., Sumpio, B. (eds) Limb Salvage of the Diabetic Foot. Springer, Cham. https://doi.org/10.1007/978-3-319-17918-6_2
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DOI: https://doi.org/10.1007/978-3-319-17918-6_2
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