Papanas N, Maltezos E
Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Greece.
Acta Clin Belg. 2007 Jul-Aug;62(4):230-8. doi: 10.1179/acb.2007.037.
The diabetic foot is a major cause of morbidity and mortality. The present review aims to outline current treatment options for this ghastly diabetic complication. Although considerable progress has been achieved over the past years, there is still a long way to go. Indeed, the International Working Group of the Diabetic Foot reported 2 years ago that a lower extremity was amputated every 30 seconds due to diabetes somewhere in the world. Established therapeutic modalities (revascularisation, casting and debridement) remain the cornerstone of management. At the same time, new treatments (e.g. growth factors, bioengineered skin substitutes, extracellular matrix proteins, etc.) are continuously being developed and explored to improve treatment. Nonetheless, it should not be underestimated that both new and old treatments must be incorporated in a prudent and zealous therapeutic strategy. Essentially, only multidisciplinary foot clinics have demonstrated that the reduction of amputation rates is feasible. The endeavour should be coupled with widespread education on the elementary rules to achieve both primary and secondary prevention.
糖尿病足是发病和死亡的主要原因。本综述旨在概述这种可怕的糖尿病并发症目前的治疗选择。尽管在过去几年中取得了相当大的进展，但仍有很长的路要走。事实上，糖尿病足国际工作组两年前报告称，在世界某些地方，每30秒就有一条下肢因糖尿病而被截肢。既定的治疗方式（血管重建、石膏固定和清创术）仍然是治疗的基石。与此同时，新的治疗方法（如生长因子、生物工程皮肤替代品、细胞外基质蛋白等）也在不断研发和探索，以改善治疗效果。尽管如此，不应低估的是，新老治疗方法都必须纳入谨慎而积极的治疗策略中。从本质上讲，只有多学科足部诊所证明了降低截肢率是可行的。这项努力应与关于基本规则的广泛教育相结合，以实现一级和二级预防。
