PC Diabetic Foot Care & Wound Management 2 — Questions and Answers
Question 1: Which debridement technique is generally preferred for a large, stable diabetic foot ulcer with thick slough and no signs of acute infection?
- Enzymatic debridement
- Autolytic debridement with hydrocolloid
- Sharp/surgical debridement (Correct answer)
- Wet-to-dry dressing changes
Correct answer: Sharp/surgical debridement
Sharp or surgical debridement is the preferred method for removing devitalized tissue quickly and effectively in stable diabetic ulcers, stimulating the wound healing cascade.
Question 2: Which organism is most commonly identified as the primary pathogen in non-limb-threatening diabetic foot infections?
- Pseudomonas aeruginosa
- Staphylococcus aureus (Correct answer)
- Bacteroides fragilis
- Streptococcus agalactiae
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA strains, is the most frequently isolated organism in non-limb-threatening diabetic foot infections.
Question 3: What is the primary goal of total contact casting in diabetic foot ulcer management?
- Prevent secondary infection
- Redistribute plantar pressure away from the ulcer site (Correct answer)
- Immobilize the ankle joint to reduce edema
- Provide antibacterial protection to the wound
Correct answer: Redistribute plantar pressure away from the ulcer site
Total contact casting redistributes plantar pressure across a wider surface area, reducing focal pressure at the ulcer site to promote healing.
Question 4: A podiatrist is treating a diabetic foot ulcer that has failed to reduce in size by 50% after 4 weeks of standard care. According to evidence-based guidelines, what is the next best step?
- Continue standard wound care for another 4 weeks
- Initiate negative pressure wound therapy (NPWT)
- Refer for advanced adjunctive therapies such as cellular/tissue-based products (Correct answer)
- Begin systemic antibiotics empirically
Correct answer: Refer for advanced adjunctive therapies such as cellular/tissue-based products
Wounds that fail to reduce by 50% in 4 weeks with standard therapy should prompt consideration of advanced adjunctive treatments such as bioengineered skin substitutes or growth factors.
Question 5: Which HbA1c level threshold is associated with significantly impaired wound healing in diabetic patients?
- Above 6.5%
- Above 7.0%
- Above 8.0% (Correct answer)
- Above 9.0%
Correct answer: Above 8.0%
HbA1c above 8.0% is associated with significantly impaired immune response and wound healing, making glycemic optimization essential in diabetic foot ulcer management.
Question 6: When probing a diabetic foot ulcer and the probe contacts bone (positive probe-to-bone test), what does this most strongly suggest?
- Deep tissue abscess
- Osteomyelitis (Correct answer)
- Sinus tract formation only
- Charcot joint collapse
Correct answer: Osteomyelitis
A positive probe-to-bone test has a high positive predictive value for osteomyelitis in diabetic foot ulcers, indicating bone has been reached through the ulcer.
Question 7: Which type of dressing is most appropriate for a heavily exuding diabetic foot ulcer to maintain a moist wound environment while managing excess moisture?
- Transparent film dressing
- Alginate or foam dressing (Correct answer)
- Dry gauze dressing
- Hydrogel dressing
Correct answer: Alginate or foam dressing
Alginate and foam dressings are highly absorbent and ideal for heavily exuding wounds, maintaining moisture balance without causing maceration of periwound tissue.
PC Diabetic Foot Care & Wound Management 2
Which debridement technique is generally preferred for a large, stable diabetic foot ulcer with thick slough and no signs of acute infection?