Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.


  1. Wilbright, Wayne A. MD, MS
  2. Birke, James A. PhD, PT, CPed
  3. Patout, Charles A. MD
  4. Varnado, Myra RN, CWOCN, CDE
  5. Horswell, Ron PhD


OBJECTIVE: To determine if the management of forefoot ulcerations through telemedicine is medically equivalent to ulcer care at a diabetes foot program.


DESIGN: Nonrandomized comparison of forefoot ulcer healing rates


SETTING: The Louisiana State University Health Sciences Center Diabetes Foot Program, Baton Rouge, LA, and Lallie Kemp Medical Center, Independence, LA


PARTICIPANTS: Twenty consecutive patients with diabetes were treated for neuropathic forefoot ulcerations via telemedicine consultation and 120 consecutive patients with diabetes were treated face-to-face at a diabetes foot program.


INTERVENTIONS: Management of forefoot ulcers by a certified wound care nurse trained in the use of a staged management approach algorithm and alternative off-loading methods, supported by real-time interactive telemedicine consultation.


MAIN OUTCOME VARIABLES: Forefoot ulcer healing time in days, percentage of wounds healed in 12 weeks, and healing time ratio (adjusted for age, gender, ulcer duration, location, size, crossover, and grade).


RESULTS: No differences were found between the telemedicine and diabetes foot program groups in the average forefoot ulcer healing time (43.2 + 29.3 vs. and 45.5 + 43.4 days, P = .828), the percent of forefoot ulcers healed in 12 weeks (75 % vs. 81%, P = .546) and the adjusted healing time ratio (1.40 vs 1.00, P = .104).


CONCLUSION: These data appear to support the effectiveness of real-time interactive telemedicine consultation in the management of diabetes-related forefoot ulceration.