Department of Plastic Surgery, The University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, TX 75390-9132, USA.
Med Clin North Am. 2013 Sep;97(5):807-20. doi: 10.1016/j.mcna.2013.05.001. Epub 2013 Jun 18.
Prevention is overlooked and underused, even in very high-risk patients. Prevention is best achieved within a multispecialty group of providers that have a common objective. Ideally, the team approach should include educators; physical therapists; nurses; internist; pedorthists; and vascular, orthopedic, and podiatric surgeons. The basic elements involve education, foot examination, risk classification, therapeutic shoes and insoles, and regular foot care. High-risk patients need additional assessment for vascular disease and intensive disease management, and corrective vascular and foot surgery when necessary. Basic interventions can reduce the incidence of foot ulcers by more than 50%.
预防措施被忽视且未得到充分利用，即使在高危患者中也是如此。预防措施最好在具有共同目标的多专科提供者小组中实现。理想情况下，团队方法应包括教育者、物理治疗师、护士、内科医生、矫形鞋治疗师以及血管外科医生、骨科医生和足病医生。基本要素包括教育、足部检查、风险分类、治疗性鞋子和鞋垫以及定期足部护理。高危患者需要进一步评估血管疾病并进行强化疾病管理，必要时还需要进行血管和足部手术矫正。基本干预措施可以使足部溃疡的发生率降低 50%以上。
