Knighton D R, Fiegel V D
Institute for Reparative Medicine, St. Louis Park, Minnesota, USA.
Curr Opin Gen Surg. 1993:32-9.
In diabetic patients, nonhealing cutaneous ulcers are a significant clinical, social, and healthcare problem. Based on more than 10 million diabetic patients in the United States and an estimated prevalence of 15% for chronic cutaneous ulcers, there are approximately 1.5 million patients with this problem. These nonhealing cutaneous ulcers result in a high rate of lower extremity amputations in the diabetic population. Patients with diabetes have many complications that cause chronic cutaneous ulcers. These include peripheral vascular disease, autonomic and sensory neuropathy, impaired host defense against infection, and delayed wound repair. To treat diabetic patients with chronic cutaneous ulcers effectively all the complicating factors must be addressed. In this review we discuss the surgical care of these patients and the use of growth factors in combination with a comprehensive treatment algorithm.
在糖尿病患者中，皮肤溃疡不愈合是一个重大的临床、社会和医疗保健问题。据美国超过1000万糖尿病患者以及慢性皮肤溃疡估计患病率为15%计算，约有150万患者存在这一问题。这些皮肤溃疡不愈合导致糖尿病患者下肢截肢率很高。糖尿病患者有许多引发慢性皮肤溃疡的并发症。这些并发症包括外周血管疾病、自主神经和感觉神经病变、宿主抗感染防御功能受损以及伤口修复延迟。为有效治疗患有慢性皮肤溃疡的糖尿病患者，必须解决所有这些复杂因素。在本综述中，我们讨论这些患者的外科治疗以及生长因子与综合治疗方案联合使用的情况。
