Nottingham University Hospitals Trust, Nottingham, UK.
VA Puget Sound Health Care System, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA.
Lancet Diabetes Endocrinol. 2024 Jul;12(7):472-482. doi: 10.1016/S2213-8587(24)00110-4. Epub 2024 May 30.
In this Review, we aim to complement the 2023 update of the guidelines of the International Working Group on the Diabetic Foot. We highlight the complexity of the pathological processes that underlie diabetes-related foot ulceration (DFU) and draw attention to the potential implications for clinical management and outcome. Variation observed in the incidence and outcome of DFUs in different communities might result from differences in study populations and the accessibility of care. Comparing differences in incidence, management, and outcome of DFUs in different communities is an essential component of the quality of disease care. Additionally, these comparisons can also highlight the relationship between DFU incidence, management, and outcome and the structure of local clinical services and the availability of staff with the necessary skills. The clinical outcome is, however, also dependent on the availability of multidisciplinary care and the ability of people with DFUs to gain access to that care.
在这篇综述中,我们旨在补充国际糖尿病足工作组 2023 年更新的指南。我们强调了导致糖尿病相关足部溃疡(DFU)的病理过程的复杂性,并提请注意其对临床管理和结果的潜在影响。不同社区中 DFU 的发生率和结果的差异可能是由于研究人群和护理的可及性的不同。比较不同社区中 DFU 的发生率、处理和结果的差异是疾病护理质量的重要组成部分。此外,这些比较还可以突出 DFU 的发生率、处理和结果与当地临床服务的结构以及具有必要技能的人员的可用性之间的关系。然而,临床结果也取决于多学科护理的可用性以及 DFU 患者获得这种护理的能力。