Location of lower-extremity diabetic foot ulcers with concomitant arterial or venous disease

Diabetes remains a highly prevalent systemic illness associated with significant morbidity, mortality and economic burden. This study investigated whether diabetic foot ulcer (DFU) location affects outcomes. Ninety-three DFU patients categorised as having diabetes only, diabetes plus peripheral arterial disease, or diabetes plus venous insufficiency, were included in this retrospective study. DFUs were identified as forefoot, mid/hindfoot or lower leg ulcers. Data on wound healing, further surgery and amputation were collected. The majority (59%) of the diabetes- only group and half the peripheral arterial disease group had forefoot ulcers. Most (78%) of the venous insufficiency group had lower leg ulcers. Overall, 25.5% of patients achieved wound closure and 18.2% underwent amputation. Forefoot ulcers were most likely to heal and hindfoot ulcers most likely to result in amputation. Healing and amputation rates differed based on DFU location and the presence of concomitant vascular disease.