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EWMA Diabetic Foot Committee - Standard of Care for diabetic foot ulcers

Introduction

The standard treatment for diabetic foot ulcers (SoC) is based on five pillars, as defined by the IWGDF guidelines:

  • Metabolic control of diabetes and its comorbidities
  • Vascular restoration in cases of peripheral arterial disease
  • Treatment of infection
  • Offloading of the diabetic foot ulcer by means of devices or surgery
  • Local management of the diabetic foot ulcer
The concept of Standard of Care (SoC) is universally accepted and is commonly used as a comparative group in most randomized clinical trials to evaluate the therapeutic advantage of the studied therapy.

After reviewing the literature, approximately 28 different SoC definitions have been found, indicating that the term SoC is not homogeneous but is subject to cultural adaptations, and differences in its definition may result in varying patient outcomes.

The objective of this questionnaire is to assess the main discrepancies in the assumption of what SoC means and its implementation in daily clinical practice, focusing on the aspects of offloading and local care of diabetic foot ulcers.


We thank you sincerely for your participation in the survey, and we will thank you twice more if you spread the word about this initiative among your contacts. The broader the response, the stronger and more widespread the diabetic foot care network across Europe will become.

Best regards,
The EWMA DFU Committee
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Estimated Completion Time and Access
The survey will take approximately 10-15 minutes to complete.
You can pause and return to the survey later as long as you use the same device and browser, and cookies are enabled. Your answers will be saved automatically.

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1.In what country do you work?
2.What is your profession?
3.Define the most commonly used offloading device in your clinical practice for pressure relief of diabetic foot ulcers:
4.Define the offloading device of choice for pressure relief of plantar neuropathic diabetic foot ulcers or DFUs with mild ischemia or DFUs with mild infection:
5.Define the offloading device of choice for pressure relief of plantar diabetic foot ulcers with mild ischemia and mild infection:
6.Define the offloading device of choice for pressure relief of plantar diabetic foot ulcers with moderate ischemia or moderate infection:
7.Define the criteria (maximum of 5) you consider when selecting the offloading device for pressure relief of a diabetic foot ulcer:
8.Indicate by proportions (maximum 100%), the most frequent location of ulcers managed in your center:
9.Indicate by proportions (maximum 100%), the most frequently used offloading method for pressure relief of diabetic foot ulcers managed in your center:
10.Indicate the procedure of choice for pressure relief of ulcers located in the distal toes in neuropathic patients:
11.Indicate the procedure of choice for pressure relief of ulcers located in the distal toes in neuroischemic patients:
12.Indicate whether the offloading devices used in your clinical practice are reimbursed:
13.Indicate whether the offloading devices used in your clinical practice are reimbursed:
14.Indicate which member of the diabetic foot care team is responsible for the application and follow-up of offloading devices for pressure relief of diabetic foot ulcers:
15.Indicate the main barriers (maximum of 2) to implementing the offloading devices recommended by the IWGDF guidelines:
16.Indicate the clinical assessment method you use to determine whether a diabetic foot ulcer is progressing appropriately:
17.Indicate the vascular assessment method used to determine the healing prognosis of a diabetic foot ulcer:
18.Regarding the debridement methods for diabetic foot ulcers, indicate the most commonly used method in your clinical practice:
19.Indicate the main reasons (maximum 2) that, in your opinion, contraindicate or limit the use of sharp debridement:
20.Indicate in which situations you choose to use enzymatic debridement instead of sharp debridement:
21.Indicate the most common debridement frequency in your routine clinical practice when the ulcer requires debridement:
22.Indicate whether you routinely use antimicrobial dressings in your clinical practice for managing diabetic foot ulcers:
23.If the previous answer is Yes, indicate under which circumstances you use antimicrobial dressings:
24.Indicate whether you use sucrose octasulfate-impregnated dressings in your routine clinical practice for managing diabetic foot ulcers:
25.If the previous answer is Yes, indicate under which circumstances you use sucrose octasulfate-impregnated dressings:
26.Indicate whether you use topical oxygen therapy in your routine clinical practice for managing diabetic foot ulcers:
27.If the previous answer is Yes, indicate under which circumstances you use topical oxygen therapy:
28.Indicate whether you use autologous patches of leukocytes, platelets, and fibrin in your routine clinical practice for managing diabetic foot ulcers:
29.If the previous answer is Yes, indicate under which circumstances you use autologous patches of leukocytes, platelets, and fibrin:
30.Indicate whether you use placental-derived products in your routine clinical practice for managing diabetic foot ulcers:
31.If the previous answer is Yes, indicate under which circumstances you use placental-derived products:
32.Indicate whether you use Negative Pressure Wound Therapy (NPWT) in your routine clinical practice for managing diabetic foot ulcers:
33.If the previous answer is Yes, indicate under which circumstances you use NPWT:
34.Indicate whether you use NPWT in your routine clinical practice for treating diabetic foot ulcers that have not undergone prior surgical debridement:
35.If the previous answer is Yes, indicate under which circumstances you use NPWT for treating diabetic foot ulcers that have not undergone prior surgical debridement:
36.Indicate whether you use Saline Instillation in your routine clinical practice for post-surgical wounds of diabetic foot patients:
37.If the previous answer is Yes, indicate under which circumstances you use Saline Instillation:
38.Indicate whether you use nutritional improvement programs in your routine clinical practice for treating diabetic foot ulcers:
39.Would you like to invite a colleague or professional contact to join the DFU network?

Survey Link: www.surveymonkey.com/r/N8XHCLJ
Thank you very much for completing this survey.
Your input is greatly appreciated and will contribute to a better understanding of diabetic foot care practices across Europe. The results will be used by the EWMA DFU Committee to support future initiatives, improve clinical collaboration, and strengthen the European DFU network.

We look forward to sharing the outcomes with you and hope to stay connected.
The EWMA Diabetic Foot Committee is kindly supported by: Aurealis Therapeutics, Bonalive, DEBx Medical, Essity, Fidia, GCRI, Nanordica Medical, Oneness Biotech, Smith+Nephew, and Solventum.