title: A survey on the status of the management of diabetic foot in the Mediterranean region.
abstract: BACKGROUND
  We conducted a survey in order to highlight the current trends in the management of diabetic foot among vascular specialists practicing in the Mediterranean region.
  
  
  METHODS
  A survey Monkey was conducted from December 2013 to November 2014, including 10 main questions on the management of diabetic foot patients. The questionnaire was sent to vascular specialists included in the current mailing list of the Mediterranean League of Angiology and Vascular Surgery. Spearman's correlation analysis was used for statistical analysis.
  
  
  RESULTS
  The response rate was 37.5% (150/400) and 52.6% of them were practicing in a Tertiary hospital service. The diabetic foot patient management and most of the amputations were performed in Tertiary hospitals. Most responders were experienced vascular specialists (55.3%). In general specialists with high work volume performed more major amputations in diabetic patients as compared to PAD patients and adopted equally all types of interventions (open, endovascular and hybrid). In particular the most experienced specialists required more diagnostic investigations, performed more minor amputations and used endovascular approach as first line treatment in diabetic patients. A lack of multidisciplinary approach was demonstrated as referral to other specialties was suboptimal.
  
  
  CONCLUSIONS
  In the Mediterranean region, patients with diabetic foot are managed by the most experienced vascular physicians in Tertiary centers. Endovascular first approach seems to be the preferred strategy, but services were able to provide open as well as hybrid procedures. Finally, the multidisciplinary team approach has not been adopted as part of the standard care even in tertiary centers.
authors: Department of Vascular Surgery, Faculty of Medicine, University Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece - spanos.kon@gmail.com.
authors: Konstantinos
authors: K
authors: Spanos
authors: Vasileios
authors: V
authors: Lachanas
authors: Christos
authors: C
authors: Karathanos
authors: Pavel
authors: P
authors: Poredos
authors: Eman
authors: E
authors: Hussein
authors: Athanasios D
authors: AD
authors: Giannoukas
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D017719:Diabetic Foot / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D019083:Mediterranean Region; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers