As the number of people diagnosed with diabetes continues to rise, the various complications related to the disease become of more pressing concern to the medical community. The diabetic foot is among these possible complications. Diabetes can lead to nerve damage and poor circulation in the extremities, which then leaves the diabetic patient susceptible to infections and deformities of the foot. Written from the perspective of the Podiatrist, Vascular Surgeon, and Infectious Disease Specialist, this comprehensive text is an essential resource for Physicians dealing with the management of complex diabetic foot problems. Adopting a multi-discipline approach, High Risk Diabetic Foot addresses: the vascular disease that can lead to diabetic foot the neuropathic impact of diabetes on the patient's extremities possible infections and deformities, like the Charcot Foot various therapy options from pharmaceutical options, to orthopedic devices, to surgical options amputation issues, such as prevention and rehabilitation the growing importance of foot clinics Lawrence A. Lavery, D.P.M. M.P.H., is a Professor in the Department of Plastic Surgery and Orthopaedic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas. A Podiatrist with over twenty years of experience, Dr. Lavery is the Medical Director of the Comprehensive Wound Care Center at the University of Texas. He is the Past Chair of the Foot Care Council for the American Diabetes Association and serves on the Infectious Diseases Committee for the International Working Group on the Diabetic Foot. Edgar J.G. Peters, M.D., Ph.D., is an Internist and Infectious Disease Specialist with the University Medical Center, Utrecht in the Netherlands. After receiving his medical degree from Vrije University Medical Centre in Amsterdam, Dr. Peters worked at Dr. Karel Bakker's foot clinic. His extensive research includes his Ph.D. thesis on risk assessment of diabetic foot complications. He is actively involved in the development of guidelines for diagnosing and treating diabetic foot infections, both as a Secretary of the International Working Group on the Diabetic Foot and within the Infectious Disease Society of America. Ruth L. Bush, M.D., M.P.H., Associate Professor of Surgery at the Texas A&M College of Medicine, is a Vascular surgeon practicing at the Scott & White Hospital in Temple, Texas. At the Scott & White Hospital, she is Director of the Vein Care Center. She is also Chief of Vascular Surgery at the Olin E. Teague VA medical Center. Since earning her medical degree from the University of North Carolina School of Medicine, Dr. Bush has authored over 100 peer-reviewed publications. She is a Fellow of the American College of Surgeons and is on the Board of Directors for the Society for Vascular Surgery.

Preface Contributors 1 Peripheral arterial disease 1 2 Clinical and vascular laboratory assessment of peripheral vascular disease by Ruth L. Bush 9 3 Endovascular treatment of infrainguinal arterial disease by Mark G. Davies 28 4 Open arterial reconstruction of the diabetic foot by Firas F. Mussa 35 5 Diabetic neuropathy and the lower extremity by Eric K. Peden 49 6 Painful diabetic neuropathy by Hans H. Savelberg 65 7 Advanced therapies to treat diabetic foot ulcers by Rayaz A. Malik 80 8 The infected diabetic foot by George T. Liu 92 9 Offloading the diabetic foot by Edgar J.G. Peters 127 10 Surgical approach to the diabetic foot ulcer by Sicco A. Bus 155 11 Charcot arthropathy by Douglas P. Murdoch 173 12 Amputation by Javier La Fontaine 192 13 Preventing foot complications by K.G. Jones 216 14 Impact of specialized foot clinics by Agbor Ndip 227 Index by Kristien Van Acker 257