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 essential elements of DFU (“i”schemia, “D”eformity, “O”ff-loading) are added to the TIME concept.
