Rorive Marcelle, Scheen André J
Service de diabétologie, nutrition et maladies métaboliques, CHU Sart Tilman, 4000 Liège, Belgique.
Rev Med Suisse. 2019 Aug 21;15(659):1448-1452.
The management of diabetic foot requires a rapid intervention in front of any type of wound, if possible by a multidisciplinary team. The daily diabetic foot screening is the best prevention. Peripheral neuropathy leads to articular deformations, loss of pain alert and skin dryness. Arteriopathy, which is also frequent, retards cicatrisation of wounds, with a higher risk of infection and amputation. Meticulous local care and foot pressure off-loading are essential, with, if needed, appropriate antimicrobial therapy. Surgery, with curative, preventive or even restorative interventions, occupies an increasing place. The evaluation, treatment and follow-up of the diabetic foot should follow new guidelines established by the IWGDF.
糖尿病足的管理需要在出现任何类型伤口时迅速干预,如有可能应由多学科团队进行。每日进行糖尿病足筛查是最佳预防措施。周围神经病变会导致关节畸形、疼痛警示丧失和皮肤干燥。同样常见的动脉病变会延缓伤口愈合,增加感染和截肢风险。细致的局部护理和减轻足部压力至关重要,必要时需进行适当的抗菌治疗。手术,包括根治性、预防性甚至修复性干预,所占比重日益增加。糖尿病足的评估、治疗和随访应遵循国际糖尿病足工作组制定的新指南。