Nigi Laura, Fondelli Cecilia, de Donato Gianmarco, Palasciano Giancarlo, Setacci Carlo, Dotta Francesco
Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Azienda Ospedaliera Universitaria Senese, Siena, Italy; Vascular Surgery Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Semin Vasc Surg. 2018 Jun-Dec;31(2-4):49-55. doi: 10.1053/j.semvascsurg.2018.12.003. Epub 2018 Dec 20.
Diabetic foot ulcer is a costly and serious complication of diabetes mellitus and is the major cause of non-traumatic limb amputations worldwide. Its development is primarily the result of diabetic neuropathy and/or peripheral arterial disease with accompanied bone abnormalities and is complicated by invasive infection. The management of this clinical condition focuses on identification of the "at-risk" foot, treatment of the ulcerated foot, and prevention of further complications. As diabetic foot ulcer represents the sum of multiple etiologies, its treatment requires a multidisciplinary team, which can result in a significant reduction in the incidence of ulcers, infections and amputations. The team should include a diabetologist, a podiatrist, an orthoptist, an educator and a plaster technician, in close collaboration with a vascular surgeon, an orthopedic/podiatric surgeon and a dermatologist. It is recommended that a diabetologist be the multidisciplinary team leader, as diabetic foot ulcer is a complication of diabetes and chronic hyperglycemia represents the main cause for its development. The appropriate composition of professionals involved in the team is institution-dependent and may vary worldwide, depending on the diabetic population. The concept of establishing a diabetic foot care team is recommended by all National and International Diabetes Scientific Societies and Associations.
糖尿病足溃疡是糖尿病一种代价高昂且严重的并发症，是全球非创伤性肢体截肢的主要原因。其发展主要是糖尿病神经病变和/或外周动脉疾病伴骨骼异常的结果，并伴有侵袭性感染。这种临床病症的管理重点在于识别“高危”足部、治疗溃疡足部以及预防进一步的并发症。由于糖尿病足溃疡是多种病因的综合表现，其治疗需要一个多学科团队，这可显著降低溃疡、感染和截肢的发生率。该团队应包括一名糖尿病专家、一名足病医生、一名视光矫正师、一名教育工作者和一名石膏技师，并与血管外科医生、骨科/足科外科医生和皮肤科医生密切协作。建议由糖尿病专家担任多学科团队负责人，因为糖尿病足溃疡是糖尿病的并发症，而慢性高血糖是其发展的主要原因。参与团队的专业人员的适当构成因机构而异，并且在全球范围内可能因糖尿病患者群体不同而有所差异。建立糖尿病足护理团队的理念得到了所有国家和国际糖尿病科学学会及协会的推荐。
