*Assessment of Diabetic Foot DOI: http://dx.doi.org/10.5772/intechopen.106731*

influence of physiological factors like arteriolar shunting and neuropathy associated with Diabetes [30]. A complete physical examination should be carried out in any patient with Diabetic foot ulceration, particularly, a detailed medical history and assessment of peripheral pulses – however, clinical examination alone cannot reliably assess the severity of perfusion deficit [31]. In order to perform a detailed assessment of the peripheral artery and its perfusion, more tests are indeed necessary.

Commonly used imaging techniques like Duplex ultrasound and Angiography allow only the assessment of the morphological distribution of Peripheral artery disease and also provide some information on the global perfusion deficit. Patients with Ischaemic foot ulceration have compartmental perfusion deficit, in which the degree of perfusion at the actual area of tissue loss cannot be identified. Therefore, assessment of foot perfusion in a patient with diabetic foot ulcer should also include the regional tissue perfusion deficit [30].

## **5.1 Assessment of disease severity**

The patients with diabetic foot ulceration should be evaluated for the presence of Peripheral artery disease during the time of presentation and they have to be managed in a multi-disciplinary setting [32–34]. The assessment of disease severity can be carried out using Ankle brachial pressure index, Toe pressures and Pulse volume recordings.
