Giurini John M, Lyons Thomas E
Division of Podiatry, Beth Israel Deaconess Medical Center, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA.
Int J Low Extrem Wounds. 2005 Sep;4(3):171-82. doi: 10.1177/1534734605280136.
Foot complications in patients with diabetes mellitus are a challenge to the health care industry. A great deal of expenditure is due to the management of diabetic foot complications. This places a great burden on the health care industry. It also places a great burden on those diabetic patients with foot complications and their families. Therefore, their effective management in an efficient manner is crucial to our patients. To deal with these problems, a dedicated, knowledgeable, and experienced multidisciplinary team is key. Intervention at the earliest possible time yields the best outcome. Prevention is the focus for those with no ulcerations. For those with ulcerations, prompt recognition and treatment is key. The importance of classifying ulcerations according to size, depth, presence or absence of infection, and vascular status can not be overstated. Proper offloading is vital for those with neuropathic lesions. Recognition of patients with a component of ischemia and vascular intervention to increase perfusion will aid in wound healing. Of course deep infection requires immediate drainage. All efforts of those in the multidisciplinary team are directed at the restoration and maintenance of an ulcer-free foot which is important in enabling our patients to maintain their ambulatory status.
糖尿病患者的足部并发症对医疗行业来说是一项挑战。糖尿病足部并发症的管理导致了大量支出。这给医疗行业带来了巨大负担。它也给那些有足部并发症的糖尿病患者及其家庭带来了巨大负担。因此，以高效的方式对其进行有效管理对我们的患者至关重要。要解决这些问题，一个专业、知识渊博且经验丰富的多学科团队是关键。尽早进行干预能产生最佳效果。对于没有溃疡的患者，预防是重点。对于有溃疡的患者，及时识别和治疗是关键。根据溃疡的大小、深度、有无感染以及血管状况进行分类的重要性再怎么强调也不为过。对于有神经病变的患者，适当减轻压力至关重要。识别有缺血成分的患者并进行血管干预以增加灌注将有助于伤口愈合。当然，深部感染需要立即引流。多学科团队的所有努力都旨在恢复和维持无溃疡的足部，这对于使我们的患者保持行走状态很重要。
