The basic and the practical way of treating of diabetic foot.
Developed atrophic ulcer and infected alterations of the foot, as a result of complications of DM, according to the available literature, 40-80% of the performed amputations are not necessary even though in practice they do occur. In our practice even the severely altered and infected extremities which look serious are considered as primarily a savable extremity if the conditions are present. The state of circulation of the extremity and the condition of the limb are evaluated carefully, and the sugar level is monitored continuously. According to our experience, every progressing process, the alteration of the host sugar level can be held as responsible. That is why after the early therapeutic period, careful monitoring of the insulin level is a priority. At our out-patient department we are daily confronted during routine wound inspections by cases of necrotizing osteomyelitis which to our experience are doomed for removal. In 1995 at the out-patient section of the vascular surgery ward we saw over 9000 patients, more than 500 of which included patients with diabetic angio/neuropathy complications. The nursing of this group of patients during that year only to 33 large vessel reconstructive operations and 26 cases of amputations. We conclude from the above statistics that not all cases of osteomyelitis cases should lead to limb amputation. Due to the nature of the condition, careful monitoring with early preventive measures, plus family support play a crucial role in the outcome of the condition. This complex process is better handled if special diabetic centres were set-up to monitor patients progress.
Rozsos
I
I
Department of Vascular Surgery, Baranya County Hospital, Pécs, Hungary.
Forgács
S
S
Kasza
G
G
Kollár
L
L
D000553:Ambulatory Care; D000671:Amputation, Surgical; D001786:Blood Glucose / Q000032:analysis; D003131:Combined Modality Therapy; D003925:Diabetic Angiopathies / Q000601:surgery; D017719:Diabetic Foot / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D003929:Diabetic Neuropathies / Q000601:surgery; D005528:Foot / Q000098:blood supply; D005534:Foot Diseases / Q000601:surgery; D006782:Hospitals, Special; D006801:Humans; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D007866:Leg / Q000098:blood supply; D008991:Monitoring, Physiologic; D009336:Necrosis; D010019:Osteomyelitis / Q000601:surgery; D019651:Plastic Surgery Procedures; D012039:Regional Blood Flow; D012944:Social Support; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
D001786:Blood Glucose; D007328:Insulin