International Journal of Surgical Wound Care
Online ISSN : 2435-2128
Brief Communication
iTIME-DO, A New Assessment / Treatment Strategy Framework for Diabetic Foot Ulcers Considering Ischemia, Deformity and Off-Loading
Mamoru Kikuchi
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2024 Volume 5 Issue 2 Pages 87-90

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Abstract
Effective management of diabetic foot ulcers requires thorough evaluation and standardized treatment protocols. A well-defined framework is crucial for clinical quality, preventing the omission of critical aspects. While existing frameworks like the “TIME Concept” excel in chronic wound treatment, they lack specific elements vital for diabetic foot ulcers. The proposed “iTIME-DO” framework focuses on diabetic foot ulcers, incorporating “i” for ischemia before “TIME” and introducing “D” for deformity and “O” for off-loading after “TIME”, addressing crucial aspects for foot lesions. There are frameworks and scoring systems for chronic limb-threatening ischemia and diabetic foot ulcers, including ischemia and neuropathy as factors. However, in the real clinical setting of diabetic foot lesions, where recurrence is common, it is essential to evaluate not only ischemia and neuropathy, but also foot deformity and loading, always considering them as important treatment factors. Treating diabetic foot ulcers involves a complex combination of elements. A systematic examination of the framework’s elements and their treatment methods will ensure that nothing is overlooked, and treatment is provided at the optimal time. The iTIME-DO framework will contribute to preventing complications and shortening treatment time by focusing on ischemia and diabetic foot deformities at the onset of treatment.
The “iTIME-DO” framework for diabetic foot ulcers. Fullsize Image
The essential elements of DFU (“i”schemia, “D”eformity, “O”ff-loading) are added to the TIME concept.
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© Japan Society for Surgical Wound Care 2024
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