ABSTRACT
At some time in their life, 15% of people with diabetes develop foot ulcers, which are highly susceptible to infection (1). These may spread rapidly leading to overwhelming tissue destruction and amputation. Eighty-five percent of amputations are preceded by an ulcer (2) and there is anamputation every 30 seconds throughout theworld (3). However,major advances have taken place. Evidence-based protocols for diabetic foot ulcers have been developed (4). Diabetic foot programs that have promoted amultidisciplinary approach to heal foot ulcerswith aggressive management of infection and ischemia have achieved a substantial decrease in amputation rates (5,6). Furthermore, a reduction in amputationshasbeen reportednationwide in diabetic patients throughout the Netherlands (7). Recently, a decrease in major amputation incidence has been reported in diabetic as well as in nondiabetic patients in Helsinki (8).
