Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon; Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon; Center for Evidence-Based Anatomy, Sport & Orthopedics Research, Lebanon.
Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon.
Foot Ankle Surg. 2022 Aug;28(6):670-679. doi: 10.1016/j.fas.2021.08.006. Epub 2021 Aug 27.
Limb preserving surgery for the treatment of diabetic foot complications (DFC) has been shown to yield excellent results and better outcomes when compared to non-surgical standard of care. The quality of the articles reporting the results of limb preserving surgery in treating DFC is quite low. The aim of this study was to evaluate the published systematic reviews and meta-analyses that looked at the efficacy of limb preserving surgery in treating DFC.
PubMed, Cochrane Library and Google Scholar were searched for all systematic reviews and meta-analyses on limb preserving surgery in DFC. The Joanna Briggs Institute (JBI) critical appraisal tool for systematic reviews was used to appraise studies' quality.
22 systematic reviews and meta-analyses with a total of 10,559 patients met the inclusion criteria. Five reviews reported on surgical treatment of diabetic Charcot, 5 reviews on bony procedures and 12 reviews on soft tissue procedures for treating DFU. The results of each review were reported. The vast majority of the studies were of Level IV of evidence. The mean JBI score was 9.82.
There is an underuse of the available limb preserving operations for the treatment of DFC despite excellent results and variety of procedures available in the literature, especially for Charcot neuroarthropathy and diabetic foot and toe ulcers.
与非手术标准治疗相比，肢体保留手术治疗糖尿病足并发症（DFC）已被证明可取得优异的效果和更好的结果。报告肢体保留手术治疗 DFC 结果的文章质量相当低。本研究旨在评估已发表的系统评价和荟萃分析，以评估肢体保留手术治疗 DFC 的疗效。
在 PubMed、Cochrane Library 和 Google Scholar 上搜索了所有关于肢体保留手术治疗 DFC 的系统评价和荟萃分析。使用 Joanna Briggs Institute（JBI）系统评价工具对研究质量进行评估。
共有 22 篇系统评价和荟萃分析，共纳入 10559 例患者。5 篇综述报道了糖尿病性夏科氏骨关节炎的手术治疗，5 篇综述报道了骨手术，12 篇综述报道了治疗 DFU 的软组织手术。报道了每个综述的结果。大多数研究的证据水平为 IV 级。平均 JBI 得分为 9.82。
尽管文献中有大量可供选择的治疗方法，包括治疗糖尿病性夏科氏骨关节炎和糖尿病足和脚趾溃疡的手术方法，但肢体保留手术治疗 DFC 的应用不足。
