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CME: Treatment of Diabetic Foot Ulcers (DFU) Using Percutaneous Ultrasonic Needle Treatment

Activity Description / Statement of Need:

In this online, self-learning activity:

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. While there are many complications resulting from this disease, this CME proposal focuses on treating diabetic foot ulcers that occur in the setting of peripheral neuropathy. Diabetic foot complications are the most common cause of non-traumatic foot injuries leading to amputation, and are also the most frequent reason for hospitalization in patients with diabetes in the United States Diabetic wound care treatments are varied with mixed results, and all current methods require some degree of medium to long-term follow-up and management by an interdisciplinary team which is costly and a significant burden to both the patients and the healthcare system as a whole.

A single treatment with an ultrasonic probe has demonstrated a high rate of complete healing with low recurrence and complication rates. Using these types of devices are relatively inexpensive when compared to more extensive and complex wound care regimens and are easily learned by those experienced in managing this condition. The treatment of diabetic foot ulcers with ultrasonic probes is an evolving standard of care and is becoming an alternative to traditional treatments. This treatment involves fragmenting, emulsifying, and removing thickened scar tissue beneath the wound crater, as well as removing osseous prominences to decrease pressure on the wound bed and promote healing.

There have been recent developments in the available treatments for diabetic foot ulcers. Communicating related information to HCPs, including recent guideline updates, is a demonstrated need.

Target Audience:

The following HCPs who specialize in diabetic care: Endocrinologists, podiatrists, foot and ankle surgeons, primary care physicians, physician assistants, nurse practitioners, and wound care RNs.

Commercial Support Disclosure: This program is supported by an educational grant from Tenex / Trice Medical.

This activity is free of charge.

Release Date: September 07, 2022 -- Expiration Date: September 07, 2024

Faculty: Lewis Freed, DPM


  • Diabetic foot ulcer (DFU) overview
  • Percutaneous ultrasonic needle overview
  • DFU care continuum
  • Ultrasonic energy in treatment of the DFU
  • Patient selection
  • The procedure (slides and video)
  • Clinical proof
  • Patient cases

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the social and financial impact of the diabetic foot.
  • Formulate a treatment algorithm for diabetic foot ulcer.
  • List the benefits of ultrasonic energy.
  • Describe the technique and rational of ultrasonic percutaneous debridement of diabetic foot ulcers.


ACCME Activity #202334954

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure: Lewis Freed, DPM, Podiatric Surgeon, OrthoArizona, has received financial compensation for consulting work from Tenex.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Tenex / Trice Medical.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Reducing vascular events and disease progression in type 2 diabetes (T2DM) and optimizing delivery of care