Approximately 6000 people with diabetes undergo leg, foot, or toe amputations each year in England, many of which are avoidable. The risk of lower extremity amputation for people with diabetes is ≥20 times that of people without diabetes. Major amputation rates in people with diabetes vary ten-fold across primary care trusts (Diabetes UK, 2012). The preceding event to limb amputation is often ulceration. This article discusses the management of heel pressure ulcers in patients with diabetes and questions whether there is a need for clearer guidance in regard to who is responsible for the patients care during a hospital stay. Additionally, the authors discuss whether care pathways need to be revised to ensure that patients are optimally managed, which could ultimately reduce the number of avoidable foot problems developing during acute hospital stays.
