Mizel M S
John F. Kennedy Memorial Hospital, Atlantis, Florida.
Orthop Rev. 1989 May;18(5):572-7.
The feet of diabetic patients are prone to injury because of their decreased sensation as well as their impaired blood supply. The injury is usually thermal, chemical, or mechanical, and treatment requires a team approach. Evaluation should include vascular and radiologic studies. Treatment, either surgical or nonsurgical, should be aggressive, to attempt to save a limb at risk for loss. Amputation should be personalized with the goal of removing the least tissue consistent with infection resolution. The prevention of future problems, both for the affected foot and the contralateral limb, should not be forgotten, and the many actions patients can take to protect their feet in the future should be stressed.
糖尿病患者的足部由于感觉减退以及血液供应受损而容易受伤。损伤通常是热损伤、化学损伤或机械损伤,治疗需要团队协作。评估应包括血管和放射学检查。无论是手术治疗还是非手术治疗,都应积极进行,以试图挽救有截肢风险的肢体。截肢应个体化,目标是切除与感染消退相一致的最少组织。不应忘记预防未来受影响足部和对侧肢体出现问题,并且应强调患者未来可以采取的许多保护足部的措施。