Swaminathan Niranjna, Awuah Wireko Andrew, Bharadwaj Hareesha Rishab, Roy Sakshi, Ferreira Tomas, Adebusoye Favour Tope, Ismail Isma Farah Nurlisa Binti, Azeem Saleha, Abdul-Rahman Toufik, Papadakis Marios
School of Medicine Taylor's University Selangor Malaysia.
Faculty of Medicine Sumy State University Sumy Ukraine.
Health Sci Rep. 2024 Apr 29;7(5):e2075. doi: 10.1002/hsr2.2075. eCollection 2024 May.
Diabetic Foot Ulcers (DFUs) are a significant health concern, particularly in Low- and Middle-Income Countries (LMICs). This review explores key strategies for managing DFUs in LMICs, including integrating podiatry, endocrinology, and wound care services, educating patients, promoting self-care, and preventive measures to reduce amputation rates.
A comprehensive literature review was conducted, focusing on studies conducted in Low and Middle Income Countries to facilitate a qualitative analysis. The review examined the aetiology and risk factors to developing DFUs, clinical presentation, multidisciplinary management and evidence based interventions, challenges to the provision of care and future directions, all pertaining to DFUs in low and middle income countries.
The aetiology and risk factors contributing to the development of DFUs are complex and multifaceted. Factors such as limited access to health care, inadequate diabetes management, and socioeconomic disparities significantly influence the incidence of DFUs. Clinical presentation varies, with patients often presenting at advanced stages of the disease due to delayed or missed diagnoses. Multidisciplinary management, incorporating podiatry, endocrinology, and wound care services, has exhibited substantial promise in enhancing patient outcomes. Evidence-based interventions, including offloading techniques, wound debridement, and the use of advanced wound dressings, have proven effective in promoting ulcer healing.
The burden of DFUs in LMICs requires comprehensive strategies. Integrating podiatry, endocrinology, and wound care services, along with patient education and self-care practices, is essential for reducing amputations and improving patients' quality of life. Regular follow-up and early detection are vital for effective DFU management, emphasizing the need for ongoing research and investment in LMIC health care infrastructure. Embracing these multidisciplinary, patient-centered approaches can effectively address the challenge of DFUs in LMICs, leading to better patient outcomes and improved quality of life.
糖尿病足溃疡(DFUs)是一个重大的健康问题,在低收入和中等收入国家(LMICs)尤为如此。本综述探讨了在低收入和中等收入国家管理糖尿病足溃疡的关键策略,包括整合足病学、内分泌学和伤口护理服务、教育患者、促进自我护理以及采取预防措施以降低截肢率。
进行了一项全面的文献综述,重点关注在低收入和中等收入国家开展的研究,以便进行定性分析。该综述研究了糖尿病足溃疡的病因和危险因素、临床表现、多学科管理和循证干预措施、提供护理面临的挑战以及未来方向,所有这些都与低收入和中等收入国家的糖尿病足溃疡有关。
导致糖尿病足溃疡发生的病因和危险因素复杂且多方面。诸如获得医疗保健的机会有限、糖尿病管理不足以及社会经济差距等因素显著影响糖尿病足溃疡的发病率。临床表现各不相同,由于诊断延迟或漏诊,患者往往在疾病晚期才前来就诊。整合足病学、内分泌学和伤口护理服务的多学科管理在改善患者预后方面显示出巨大潜力。包括减压技术、伤口清创和使用先进伤口敷料在内的循证干预措施已被证明在促进溃疡愈合方面有效。
低收入和中等收入国家的糖尿病足溃疡负担需要综合策略。整合足病学、内分泌学和伤口护理服务,以及患者教育和自我护理实践,对于减少截肢和提高患者生活质量至关重要。定期随访和早期发现对于有效的糖尿病足溃疡管理至关重要,这强调了对低收入和中等收入国家医疗保健基础设施进行持续研究和投资的必要性。采用这些多学科、以患者为中心的方法可以有效应对低收入和中等收入国家糖尿病足溃疡的挑战,从而带来更好的患者预后和更高的生活质量。