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Available in Packages/Products: PRESENT Complete Podiatric CME Online

Section: CME Category: Diabetic Foot

Mal Perforans Ulcers - A Practical Treatment Protocol

Adrienne Estes, MS, DPM

This lecture offers a practical, stepwise approach to the evaluation and management of mal perforans ulcers. Dr. Estes will review the defining clinical characteristics and biomechanical drivers of these ulcers, helping participants distinguish them from other neuropathic and ischemic foot wounds. The session will outline an evidence-based treatment protocol that integrates offloading, wound bed preparation, infection control, and strategies to improve patient adherence. Indications for advanced therapies and surgical interventions—including tendon balancing, osseous procedures, and adjunctive wound technologies—will be discussed, with a focus on reducing recurrence, preventing limb loss, and optimizing long-term outcomes.

CME (Credits: 0.50)

Method of Participation

Complete the 4 steps to earn your CE/CME credit:

  1. Complete the Pre-Test
  2. View the Lecture
  3. Complete the Quiz (Min. 70% Passing Score)
  4. Complete the program Survey
Goals and Objectives
  1. Recognize the defining clinical features and biomechanical drivers of mal perforans ulcers and differentiate them from other neuropathic and ischemic foot ulcers.
  2. Develop a stepwise, evidence-based treatment protocol for mal perforans ulcers, incorporating offloading strategies, wound bed preparation, infection control, and patient adherence considerations.
  3. Evaluate indications for advanced and surgical interventions in mal perforans ulcers, including tendon balancing, osseous procedures, and adjunctive wound technologies to reduce recurrence and limb loss.
  • Accreditation and Designation of Credits
  • CME (Credits: 0.50)

    PRESENT e-Learning Systems is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. PRESENT e-Learning Systems has approved this activity for a maximum of 0.50 continuing education contact hours

    Release Date: 04/17/2026 Expiration Date: 04/17/2029

  • Author

  • Adrienne Estes, MS, DPM

    Director, Continuing Education
    Associate Professor, College of Podiatric Medicine
    Western University of Health Sciences
    Pomona, CA

  • System Requirements

  • To view Lectures online, the following specs are required:

    • Broadband Internet
    • Browsers must have javascript enabled. Most browsers have this feature enabled by default.
    • Any PDF reader. Download Adobe PDF (Free) to print certificates.
    Supported Browsers:
    • Chrome
    • Firefox
    • Microsoft Edge
    • Safari
    Supported Mobile OS:
    • Apple iOS 13+
    • Android 10+
  • Disclosure Information

  • It is the policy of PRESENT e-Learning Systems and it's accreditors to insure balance, independence, objectivity and scientific rigor in all its individually sponsored or jointly sponsored educational programs. All faculty participating in any PRESENT e-Learning Systems sponsored programs are expected to disclose to the program audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education program. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts.

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    Adrienne Estes has nothing to disclose.