**Meet the editor**

Dr. Thanh Dinh is currently an Assistant Professor in Surgery at Harvard Medical School and an Attending Podiatric Surgeon at Beth Israel Deaconess Medical Center in Boston, MA. Her clinical and research interests include Diabetic Foot Complications and Diabetic Microcirculation. She has published original research and scientific reviews in several prominent scientific journals, contributed

to a number of textbooks covering Diabetes Mellitus, and serves as a reviewer for the International Journal of Lower Extremity Wounds. She is a currently a co-investigator on an NIDDK grant, Mechanisms of Neuropeptides Action in Diabetes, and an NIH grant, Impaired Wound Healing in Diabetic Foot Ulceration. In addition to her research activities, Dr. Dinh serves as the Assistant Director of Residency Training of the Podiatric Surgical Program at BIDMC as well as the Director of Externship Education.

Contents

**Preface IX** 

Sharad Pendsey

**Part 2 Diagnostic Considerations in** 

**Part 1 Global Impact of Diabetic Foot Complications 1** 

Ezera Agwu, Ephraim O. Dafiewhare and Peter E. Ekanem

Chapter 2 **Reducing Diabetic Foot Problems and Limb Amputation:** 

Chapter 1 **Possible Diabetic-Foot Complications in Sub-Saharan Africa 3** 

**An Experience from India 15** 

**Diabetic Foot Complications 25** 

Markus Löffler, Michael Schmohl,

Julia Shaw and Patrick M. Bell

Chapter 7 **The Biomechanics of the Diabetic Foot 103** 

Chapter 8 **A Protocol for Primary Podogeriatric Assessment** 

Richard Florence

Dennis Shavelson

Arthur E. Helfand

Chapter 3 **Screening of Foot Inflammation in Diabetic Patients by Non-Invasive Imaging Modalities 27**  Takashi Nagase, Hiromi Sanada, Makoto Oe,

Chapter 4 **Wound Fluid Diagnostics in Diabetic Foot Ulcers 47** 

Nicole Schneiderhan-Marra and Stefan Beckert

Chapter 5 **Wound Measurement in Diabetic Foot Ulceration 71** 

Chapter 6 **The Temporary Orthesio-Therapy for Diabetic Foot 83** 

**for Older Patients with Diabetes Mellitus 129** 

Kimie Takehara, Kaoru Nishide and Takashi Kadowaki

## Contents

#### **Preface XI**

	- **Part 2 Diagnostic Considerations in Diabetic Foot Complications 25**

#### **Part 3 Treatment of Diabetic Foot Ulcerations 153**

Chapter 9 **The Pathogenesis of the Diabetic Foot Ulcer: Prevention and Management 155**  F. Aguilar Rebolledo, J. M. Terán Soto and Jorge Escobedo de la Peña

#### Chapter 10 **Role of Nitric Oxide in Extracellular Matrix Metabolism and Inflammation in Diabetic Wound Healing 183**  Victor L. Sylvia, Audra D. Myers, Brandon M. Seifert, Eric M. Stehly, Michael A. Weathers, David D. Dean and Javier LaFontaine

#### Chapter 11 **Nutritional Treatment of Diabetic Foot Ulcers - A Key to Success 201**  Patrizio Tatti and Annabel Barber

Chapter 12 **Intralesional Human Recombinant Epidermal Growth Factor for the Treatment of Advanced Diabetic Foot Ulcer: From Proof of Concept to Confirmation of the Efficacy and Safety of the Procedure 217**  Pedro A. López-Saura, Jorge Berlanga-Acosta, José I. Fernández-Montequín, Carmen Valenzuela-Silva, Odalys González-Díaz, William Savigne, Lourdes Morejon-Vega, Amaurys del Río-Martín, Luis Herrera-Martínez, Ernesto López-Mola and Boris Acevedo-Castro

Chapter 13 **Lactoferrin as an Adjunctive Agent in the Treatment of Bacterial Infections Associated with Diabetic Foot Ulcers 239**  Maria Elisa Drago-Serrano, Mireya De la Garza and Rafael Campos-Rodríguez

Chapter 14 **Charcot Neuro-Osteoarthropathy 271**  A.C. van Bon

## Preface

Over the last decade, it is becoming increasingly clear that diabetes mellitus is a global epidemic. The influence of diabetes is most readily apparent in its manifestation in foot complications across cultures and continents. In this unique collaboration of global specialists, we examine the explosion of foot disease in locations that must quickly grapple with both mobilizing medical expertise and shaping public policy to best prevent and treat these serious complications.

In other areas of the world where diabetic foot complications have unfortunately been all too common, diagnostic testing and advanced treatments have been developed in response. The bulk of this book is devoted to examining the newest developments in basic and clinical research on the diabetic foot. It is hoped that as our understanding of the pathophysiologic process expands, the devastating impact of diabetic foot complications can be minimized on a global scale.

> **Dr. Thanh Dinh**  Assistant Professor, Surgery, Harvard Medical School Podiatric Surgeon, Beth Israel Deaconess Medical Center Boston, USA

**Part 1** 

**Global Impact of Diabetic Foot Complications** 
