Sumpio B E
Department of Surgery (Vascular), Yale University School of Medicine, New Haven, Conn 06510, USA.
N Engl J Med. 2000 Sep 14;343(11):787-93. doi: 10.1056/NEJM200009143431107.
The role of the primary care physician in the evaluation, diagnosis, and management of pedal wounds is critical (Table 2). Patient education is essential for the reduction of risk factors and for the early recognition of foot complications. Careful assessment of vascular disease (leading to bypass surgery when indicated), evaluation and management of biomechanical abnormalities, and aggressive treatment of any infections are also required. Optimal management can reduce the number of major amputations, prevent infection, decrease the probability of ulceration, maintain skin integrity, and improve function. The multidisciplinary approach will provide a comprehensive treatment protocol that will increase the long-term viability of the foot.
初级保健医生在足部伤口的评估、诊断和管理中起着至关重要的作用(表2)。患者教育对于降低危险因素和早期识别足部并发症至关重要。还需要仔细评估血管疾病(必要时进行搭桥手术)、评估和处理生物力学异常以及积极治疗任何感染。最佳管理可以减少大截肢的数量、预防感染、降低溃疡的可能性、保持皮肤完整性并改善功能。多学科方法将提供一个全面的治疗方案,从而提高足部的长期生存能力。