Brocco Enrico, Ninkovic Sasa, Marin Mariagrazia, Whisstock Christine, Bruseghin Marino, Boschetti Giovanni, Viti Raffaella, Forlini William, Volpe Antonio
Diabetic Foot Unit, Foot and Ankle Clinic, Abano Terme Polyclinic, Abano Terme, Padua, Italy -
Diabetic Foot Unit, Foot and Ankle Clinic, Abano Terme Polyclinic, Abano Terme, Padua, Italy.
J Cardiovasc Surg (Torino). 2018 Oct;59(5):670-684. doi: 10.23736/S0021-9509.18.10606-9. Epub 2018 May 29.
The diabetic foot is a complication of diabetes affecting 15% of diabetics in their lives. It is associated to diabetic neuropathy and peripheral vascular disease and its incidence has increased. The ulceration is the initial cause of a dramatic process leading, if not correctly treated, to amputations. Both neuropathy, neuro-ischemia and infections have a role in determining healing or worsening of the lesions and 85% of all amputations in diabetic patients are preceded by a foot ulceration deteriorating to a severe gangrene or infection. The different causative agents and the different clinical presentations of diabetic foot ask a multidisciplinary approach in order to address treatments to the final goals, the prevention of the amputations and the maintenance of a functional foot able with weight-bearing ability. Many professional figures, diabetologists, surgeons (both general and vascular and orthopedics), interventional radiologists, infectious diseases specialists, specialized nurses, podiatrists, orthotic technicians, are called to apply their knowledges to the diabetic patients affected by diabetic foot in a virtuous circle leading to reach the goals, with the imperative action of the multidisciplinary team. The so organized center will allow both a correct and rapid diagnosis, the use in ambulatorial environments of modern tools, or the hospitalization in multitasking wards, in which all the complications and the necessary treatments are possible, both in emergencies or in elective way, considering both revascularizations and surgery.
糖尿病足是糖尿病的一种并发症，在糖尿病患者一生中的发病率为15%。它与糖尿病神经病变和周围血管疾病相关，且发病率呈上升趋势。溃疡是一个严重过程的初始原因，若未得到正确治疗，会导致截肢。神经病变、神经缺血和感染在决定病变愈合或恶化方面均起作用，糖尿病患者中85%的截肢手术之前都有足部溃疡恶化为严重坏疽或感染的情况。糖尿病足的不同致病因素和不同临床表现需要多学科方法，以便针对最终目标进行治疗，即预防截肢并维持具有负重能力的功能性足部。许多专业人员，包括糖尿病专家、外科医生（普通外科、血管外科和骨科）、介入放射科医生、传染病专家、专科护士、足病医生、矫形技师，都被要求将他们的知识应用于患有糖尿病足的糖尿病患者，形成一个良性循环以实现目标，这需要多学科团队的关键作用。如此组织的中心将既能实现正确、快速的诊断，又能在门诊环境中使用现代工具，或在多任务病房住院，在这种病房里，无论是急诊还是择期，考虑到血管重建和手术，所有并发症及必要治疗都是可行的。
