Falkenberg M, Apelqvist J, Rosenqvist U, Lithner F
Vårdcentralen, Kisa.
Lakartidningen. 1993 Nov 24;90(47):4221-4.
Reports of preventive management resulting in reduction, by 50 percent or more, of the incidence of major amputation due to foot ulceration in diabetics have now been published from seven different localities, five in Europe (Umeå, Kisa, Lund, London and Geneva) and two in the USA (Tucson and Louisville). The methods used to achieve the reduction are remarkably similar, being based on systematic check-ups for incipient foot ulceration and its putative risk factors. In all three Swedish reports, the work has entailed close liaison with community health centres in the respective areas, which is considered to be of the utmost importance in reaching all diabetics at risk of foot ulcers. Another important prerequisite is a specialised foot clinic for diabetic patients in each area, where the skills of a chiropodist, a physician specialised in diabetes, an orthopaedic surgeon and an orthopaedic shoemaker are available.
目前，来自七个不同地区的报告已发表，这些报告表明预防性管理使糖尿病患者因足部溃疡导致的大截肢发生率降低了50%或更多。其中五个地区在欧洲（于默奥、基萨、隆德、伦敦和日内瓦），两个地区在美国（图森和路易斯维尔）。实现这种降低的方法非常相似，都是基于对初期足部溃疡及其假定风险因素进行系统检查。在瑞典的所有三份报告中，这项工作都需要与各自地区的社区健康中心密切联络，这被认为对于接触所有有足部溃疡风险的糖尿病患者至关重要。另一个重要前提是每个地区都要有一家为糖尿病患者设立的专业足部诊所，那里有足病医生、糖尿病专科医生、整形外科医生和矫形鞋匠的专业技能。
