P.O. Campobasso - ASReM, Campobasso, Italy.
Servizi di Diabetologia, USL 3, Pistoia, Italy.
Nutr Metab Cardiovasc Dis. 2014 Apr;24(4):355-69. doi: 10.1016/j.numecd.2013.12.007. Epub 2013 Dec 25.
Diabetic foot (DF) is a chronic and highly disabling complication of diabetes. The prevalence of peripheral arterial disease (PAD) is high in diabetic patients and, associated or not with peripheral neuropathy (PN), can be found in 50% of cases of DF. It is worth pointing out that the number of major amputations in diabetic patients is still very high. Many PAD diabetic patients are not revascularised due to lack of technical expertise or, even worse, negative beliefs because of poor experience. This despite the progress obtained in the techniques of distal revascularisation that nowadays allow to reopen distal arteries of the leg and foot. Italy has one of the lowest prevalence rates of major amputations in Europe, and has a long tradition in the field of limb salvage by means of an aggressive approach in debridement, antibiotic therapy and distal revascularisation. Therefore, we believe it is appropriate to produce a consensus document concerning the treatment of PAD and limb salvage in diabetic patients, based on the Italian experience in this field, to share with the scientific community.
糖尿病足(DF)是糖尿病的一种慢性且高度致残的并发症。糖尿病患者外周动脉疾病(PAD)的患病率很高,并且与外周神经病变(PN)相关或不相关,在 50%的 DF 病例中均可发现。值得指出的是,糖尿病患者的大截肢数量仍然很高。许多 PAD 糖尿病患者由于缺乏技术专业知识或更糟糕的是由于不良的经验而产生的负面信念而未进行血运重建。尽管如今远端血运重建技术取得了进展,使得能够重新开放腿部和脚部的远端动脉,但情况依然如此。意大利是欧洲大截肢率最低的国家之一,在通过清创、抗生素治疗和远端血运重建的积极方法进行肢体挽救方面有着悠久的传统。因此,我们认为,根据意大利在这一领域的经验,编写一份关于 PAD 和糖尿病患者肢体挽救治疗的共识文件是合适的,以便与科学界分享。