Weledji Elroy P, Fokam Pius
Department of Surgery, Faculty of Health Sciences, University of Buea, PO Box 126, Limbe, S W Region, Cameroon.
BMC Surg. 2014 Oct 24;14:83. doi: 10.1186/1471-2482-14-83.
Diabetic foot infections are a frequent clinical problem. About 50% of patients with diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches.
The article debates the pros and cons of amputation of the diabetic foot. The thesis is that if the guidelines on the management of the diabetic foot are followed primary amputation is only necessary for the unsalvageable diabetic foot. This approach would reduce the incidence of lower limb amputations in diabetic patients.
We favour the argument that a structured clinical and vascular assessment would help clinical decision- making as to which patients to hospitalize, which to send for imaging, or for whom to recommend surgical interventions. Endovascular procedures are the future in the treatment of diabetic arterial disease and hence the diabetic foot.
糖尿病足感染是常见的临床问题。约50%接受足部截肢的糖尿病足感染患者会在五年内死亡。若管理得当，大多数患者可被治愈，但由于诊断和治疗方法不当，许多患者不必要地接受了截肢手术。
本文探讨了糖尿病足截肢的利弊。其论点是，如果遵循糖尿病足管理指南，仅对无法挽救的糖尿病足才需要进行初次截肢。这种方法将降低糖尿病患者下肢截肢的发生率。
我们赞同这样的观点，即结构化的临床和血管评估有助于临床决策，决定哪些患者应住院治疗、哪些患者应进行影像学检查或哪些患者应接受手术干预。血管内介入治疗是糖尿病动脉疾病及糖尿病足治疗的未来方向。
