[Diabetic foot syndrome].
The diabetic foot syndrome (DFS) is an important diabetic complication. The typical lesion is a neuropathic plantar foot ulcer which heals well when treated properly. However, complications resulting from deep infections of soft tissue or bone, together with a reduced peripheral blood flow, may necessitate amputation of the lower limbs. In general, diabetic patients have a 10-fold higher risk for amputation than non-diabetic subjects and also a poorer long-time prognosis than the latter. The target of a 50% reduction of lower limb amputations in diabetic patients, given by the St. Vincent Declaration for Europe in 1990, has not been achieved. The prevention as well as treatment of DFS have to be improved in order to achieve this target. The feet of diabetic patients must be inspected regularly and the patients must be educated appropriately. Detailed information on avoidable risk factors and the availability of protective footwear are essential for the prevention of DFS. An increasing number of ischemic diabetic subjects undergo vascular reconstruction, which yields good results. On account of the multifactorial etiology of DFS, a multidisciplinary approach is required to resolve the problem. In addition to a diabetologist, the team should include a plastic and vascular surgeon, a neurologist, a radiologist and an orthopedist.
Kästenbauer
Thomas
T
L. Boltzmann-Institut für Stoffwechselerkrankungen und Ernährung an der 3. Medizinischen Abteilung. Krankenhaus Wien-Lainz, Wolkersbergenstrasse 1, 1130 Wien, Osterreich. thomas.kaestenbauer@wienkav.at
Irsigler
Karl
K
D000671:Amputation, Surgical; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery; D017719:Diabetic Foot / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D007866:Leg / Q000098:blood supply; D023821:Limb Salvage; D012307:Risk Factors