The VIPs of diabetic foot care
Gary Sibbald and James Elliott eloquently describe their clinical mantra for treating a patient with neuropathic foot ulceration. They refer to the process as the “VIPs of care”.
V = ensuring an adequate vascular supply. Examine pulses, systolic arterial pressures (including in the great toe) and arterial waveforms.
I = infection eradication and chronic inflammation reduction. Key actions are debridement with targeted use of antimicrobial agents (both topical and systemic).
P = plantar pressure redistribution. Achieved through orthotics, shoe modifications, custom shoes and specific off-loading boots / contact casts.
They also discuss comparative findings where iodine demonstrates superior biofilm disruption compared to silver, polyhexamethylene biguanide and honey.
Sibbald RG & Elliott JA The role of Inadine in wound care: a consensus document. Int Wound J 2017;14:316-321.