Matamoros R, Riepe G, Drees P
Stiftungsklinikum Mittelrhein, Johannes-Müller-Str. 7, 56058, Koblenz, Deutschland.
Chirurg. 2012 Oct;83(10):923-33; quiz 934. doi: 10.1007/s00104-010-2054-8.
A threatening major amputation represents a fateful turning point for diabetics. This occurs in 50% of cases of amputations in diabetics. This increases the demand for another therapeutic route not only because of the limitations in quality of life but also due to substantially higher mortality. Even if an osteomyelitic ischemic situation is often present specialized centers have succeeded in substantially reducing the rate of major amputations in such patients. The term "minor amputation" commonly used in vascular surgery is not uniformly understood. Following the "vascular surgery working model" developed by Rümenapf, the significance of "minor amputations" for retention of extremities and the associated controversies have been shown. "Minor amputations" therefore represent a maxi-task if patients undergoing such a procedure are to be timely and competently treated. The necessary interdisciplinary cooperation with other specialists should in the future also include orthopedic surgeons.
一次具有威胁性的大截肢对糖尿病患者来说是一个决定性的转折点。这种情况发生在糖尿病患者截肢病例的50%中。这不仅由于生活质量受限,还因为死亡率大幅升高,从而增加了对另一种治疗途径的需求。即使常常存在骨髓炎缺血情况,专业中心仍成功大幅降低了这类患者的大截肢率。血管外科常用的“小截肢”一词并未得到统一理解。遵循吕梅纳普提出的“血管外科工作模式”,已表明“小截肢”对保留肢体的意义及相关争议。因此,如果要对接受此类手术的患者进行及时、有效的治疗,“小截肢”是一项艰巨的任务。未来与其他专科医生进行必要的跨学科合作时,也应包括骨科医生。