Consensus on diabetic foot
Keywords:
diabetes, diabetic foot, physiopathology, prophylaxis, treatment, consensusAbstract
The 1st Hospital Meeting took place on 16 March 1996, under the theme "Diabetic Foot': lt gathered in Coimbra eighteen doctors of different specialities, who spend a major part of their professional lives dealing with this situation. From that informal exchange of knowledge and personal experience, with sharing of successes and failures, a collection of points has resulted, upon which they were all agreed and that are presented in this paper, together with the recent opinions of severa[ authors who also support them. This paper is mainly meant to be a practi cal help to those who fight against that social problem in our country.
Downloads
References
Gama A. D. Pé Diabético - Perspectivas Actuais de Diagnóstico e Tratamento. Rev Port Cir Cardio-Torác Vasc III 1995; (6): 29-36.
Leutenegger M, Malgrange D, 13occalon H, Fontaine P, Got I, Valensi P, Yomtov 13. Le Pied Diabétique. Diabete Metab 199';; 21(6): 452-457.
Murray HJ, Boulton AJ. The Pathophysiology of Diabetic Foot Ulceration. Clin Podiatr Med Surg 1995; 12(1) 1-17.
Nathan DM. Long-term complications of diabetes mellitus. N EngJ Med, 328: 1676, 1993.
Sedlarik KM, Piatek S, Reusche S, Lippert H. Impaired Wound Healing as a Result of Systemic Diseases. J Wound Care 1995; 4(3): 119-120
Dunning T, Hew FL. Thc Anaesthetic Foot - A Case of Severe Diabetic Pcripheral Neuropathy. Aust Fam Physician 1995; 24(9) 1669-1671.
Birke JA, Franks 13D, Foto JG. First Ray Joint Limitation, Pressure. and Ulceration of the First Metatarsal Head in Diabetes Mellitus. Foot Ankle lnt 1995; 16(5): 277-284.
Kerstein MD, Polsky S. Treating Wounds Associated with De creased Sensibility. Ostomy Wound Manage 1995; 41(2): 46-51.
Mueller MJ, Sinacore DR, Hoogstrate S, Daly L. Hip and Ankle Walking Strategies: Effect on Peak Plantar Pressures anel lmplications for Neuropathic Ulceration. Arch Phys Med Rehahil 1994; 75(11): 1196-1200.
Lower RF, Kenzora JE. The Diabetic Neuropathic Foot: A Tripie Crush Syndrome - Measurement of Compartmental Pressures of Normal anel Diabetic Feet. Orthopedics 1994;17(3): 241-248.
Olmos PR, Catalancl S, O'Dorisio TM, Casey CA, Smeacl WL, Simon SR. The Semmes-Weinstein Monofilament as a Potential Predictor of Foot Ulceration in Patients with Nonin sulin-Dependent Diabetes. AmJ Mecl Sei 1995; 309(2): 76-82.
Buhler-Singer S, Hiller D, Albrecht HP, Seiclel C, Hornstein OP. Disturbances of Cutaneous Microcirculation in Patients with Diabetic Legs: Additional Parameters for a New Therapeutic Concept?. Acta Derm Venereol 1994; 74(4): 250-256.
Chew JT, Tan SR, Sivathasan C, Pavanni R, Tan SK. Vascular Assessment in the Neuropathic Diabetic Foot. Clin Orthop 1995; 320 95-100.
Creutzig A. Pathogenesis of peripheral diabetic microangiopathy. Critical lschaemia 1994; 4(3): 78-86.
Mayrovitz HN, Larsen PI3. Standard anel Near-surface Laser doppler Perfusion in Foot Dorsum Skin of Diabetic and Nondiabetic Subjects with and without Coexisting Peripheral Arterial Disease. Microvasc Res 1994; 48(3): 338-348.
Moriarty KT, l'erkins AC, Robinson AM, Wastie ML, Tattersall RB. Investigating the Capillary Circulation of the Foot with 99mTcMacroaggregated Albumin: A Prospective Study in Patients with Diabetes and Foot Ulceration. Diabet Med 1994; 11(1) 22-27.
Pozza G, Vicari AM. Haemostatic alterations in Diabetes Mellitus. Critical lschaemia 1994; 40 (1): 2-9.
Rayman G, Williams SA, Gamble J, Tooke JE. A Study of Factors Governing Fluid Filtration in the Diabetic Foot. Eur J Clin Invest 1994; 24 (12): 830-836.
Bridges RM, Deitch EA. Diabetic Foot Infections: Pathophysiology anel Treatment. Surg Clin North Am, 1994; 74(3): 537- 555.
Gibbons GW, Habershaw GM. Diabetic Foot Infections: Anatomy and Surgery. Infect Dis Clin North Am, 1995; 9(1): 131-142.
Forst T, Pfutzner A, Kann P, Lobmann R, Schafer H, Beyer J. Association Between Diabetic-Autonomic-C-Fibre-Neuro pathy anel Medial Wall Calcification and the Significance in the Outcome of Trophic Foot Lesions. Exp Clin Endocrinol Diabetes 1995; 103(2): 94-98.
McNeely MJ, Bokyo EJ, Ahroni .JH, Stensel VL, Reibel GE, Smith DG, Pecoraro RF. The Independent Contributions of Diabetic Neuropathy and Vasculopathy in Foot Ulceration. How Great are the Risks'. Diabetes Care 1995; 18(2): 216-219.
DCCT Research Group The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Eng J Med, 1993: 329 :977.
Defronzo RA, Reasner C. The "Diabetic Control and Complications Triai Study": lmplications for the Diabetic Foot. J foot Ankle Surg 1994; 33(6): 551-556.
Griffiths GD, Wieman T.J Meticulous Attention to Foot Care Improves the Prognosis in Diabetic Ulceration of the Foot. S G O. 1992; 174: 49-51.
Brink T. Induration of the Diabetic Foot Pad: Another Risk Factor for Recurrent Neuropathic Plantar Ulcers. Biomed Tech Berl 1995; 40(7-8): 205-209.
Foster A. Should podiatrists treat patients with CLI ' Critical Ischaemia 1994: 3(4): 120-124.
Albert S, Rinoie C. Effect of Custom Orthotics on Plantar Pres sun: Distribution in the Pronated Diabetic Foot.J Foot Ankle Surg 1994; 33(6): 598-604.
Janisse DJ. Prescription Insoles and Footwear. Clin Podiatr Med Surg 1995; 12( 1 ): 41-61.
Sarnow MR, Veves A, Giurini JM, Rosenhlum BI, Chrzan JS, Habershaw GM. ln-Shoe Foot Pressure Measurements in Diabetic Patients with At-Risk Feet and in Healthy Suhjects. Diabetes Care 1994; 17(9): 1002-1006.
Walker SC, Helm PA, Pullium G. Total-Contact Casting, San dais, and Insoles: Construction and Applications in a Total Foot-Care Program. Clin Podiatr Med Surg 1995; 120): 63-73
Perry JE, Ulbrecht JS, Derr JA, Cavanagh PR. The Use of Running Shoes to Reduce Plantar Pressures in Patients Who Have Diabetes. J Bone Joint Surg Am 1995; 7702): 1819- 1828.
Patel VG, Wieman TJ. Effect of metatarsal head resection for diabetic foot ulcers on the dynamic plantar pressure distribution. Am J Surg 1994; 167: 297-301.
Ehrlich KS, Rumack J.S. Evaluation and management of nonhealing infected wounds in diabetics. Highlights from: Complications in Surgery 1995; 12(3) :7-13.
Karchmer AW, Gibbons GW. Foot Infections in Diabetics: Evaluation and Management. Curr Clin Top lnfect Dis 1994; 14: 1-22.
Louie A, 13altch AL, Smith RP. Gram-Negative Bacterial Surveillance in Diabetic Patients. Highlights from: Complications in Surgery 1994; 11(2) :3-11.
West NJ. Systemic Antimicrobial Treatment of Foot lnfections in Diabetic Patients. Am J Health Syst Pharm 1995; 52( 11 ): 1199-207, Quiz 1239-1240.
Horowitz JD, Durham JR, Nease DB, Lukens ML, Wright JG, Smead WL. Prospective evaluation of magnetic resonance imaging in the management of acute diabetic foot infections. Ann Vasc Surg 1993; 7: 44-50.
j
Larsson , Agardh CD, Apelqvist J, Stenstrom A. Clinical Characteristics in Relation to Final Amputation Levei in Diabetic Patients with Foot Ulcers: A Prospective Study of Healing Below or Above the Ankle in 187 Patients. Foot Ankle lnt 1995; 16(2): 69-74.
Pinzur MS, Smith D, Osterman H. Syme Ankle Disarticulation in Peripheral Vascular Disease and Diahetic Foot Infection: The One-Stage versus Two-Stage Procedure. Foot Ankle Int 1995; 16(3): 124-127.
GISAP Group Evaluation of a conservative treatment with iloprost in severe peripheral occlusive arterial disease. Int Angiol 1994; 13: 70-74.
Loosemore TM, Chalmers TC, Dormandy JA. A Meta-analysis of randomised placebo control triais in Fontaine stages !II and IV peripheral occlusive arterial disease. Int Angiol 1994: 13(2): 133-142.
Stürzebecher S, Taschke C. lntravenous Therapy with the prostacyclin Derivative Iloprost in Severe Stages of Peripheral Arterial Occlusive Disease. Hamostaseologie 1993: 13: 73-79.
Volteas N, Leon M, Labropoulos N, Christopoulos D, Boxer D, Nicolaides A. The effect of iloprost in patients with rest pain. Eur J Vasc Surg 1993; 7 654-658.
Gibbons GW. Vascular Evaluation and Long-term Results of Distal Bypass Surgery in Patients with Diabetes. Clin Podiatr Med Surg 1995; 120): 129-140.
Isaksson L, Lundgren F. Vein bypass surgery to the foot in patients with diabetes and critical ischaemia. Br J Surg 1994; 81: 517-520
Pornposelli FBJr, Marcaccio EJ, Gibbons GW, Campbell DR, Freeman DV, Burgess AM, Miller A, LoGerfo F.W. Dorsalis Pedis arterial bypass: durable limb salvage for footischemia in patients with diabetes mellitus. J Vasc Surg 1995; 21: 375-384.
Ubbink T, Jacobs MJ. The Role of Diabetes in Criticai Limb lschaemia. Critical Ischaemia 1996; 6(1): 23-25.
Smith FCT, Thomson IA, Hickey NC, Paterson IS, Tsang GMK, Simms MH, Shearman C.P. Adjuvant Prostanoid Treatment During Femorodistal Reconstruction. Ann Vasc Surg 1993; 7(1): 88-94.
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna