Diabetic foot surgery: Difference between revisions
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==Overview== | ==Overview== | ||
One of the centerpieces of [[diabetic foot]] [[treatment]] is debridement of [[necrosis|necrotic]] and [[fibrosis|fibrotic]] [[Tissue (biology)|tissues]] as well as [[Callus|calluses]]. Debridement should be done until it reaches the [[bleeding]] [[Tissue (biology)|tissue]], which is both a [[treatment]] and a [[diagnosis|diagnostic method]] to evaluate [[ulcer]] margin and [[abscess]]'s presence. | |||
==Surgery== | ==Surgery== | ||
*One of the centerpieces of [[diabetic foot]] [[treatment]] is debridement of [[necrosis|necrotic]] and [[fibrosis|fibrotic]] [[Tissue (biology)|tissues]] as well as [[Callus|calluses]].<ref name="pmid10480782">{{cite journal| author=American Diabetes Association| title=Consensus Development Conference on Diabetic Foot Wound Care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association. | journal=Diabetes Care | year= 1999 | volume= 22 | issue= 8 | pages= 1354-60 | pmid=10480782 | doi=10.2337/diacare.22.8.1354 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10480782 }} </ref><ref name="pmid9531915">{{cite journal| author=Armstrong DG, Lavery LA| title=Diabetic foot ulcers: prevention, diagnosis and classification. | journal=Am Fam Physician | year= 1998 | volume= 57 | issue= 6 | pages= 1325-32, 1337-8 | pmid=9531915 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9531915 }} </ref> | *One of the centerpieces of [[diabetic foot]] [[treatment]] is debridement of [[necrosis|necrotic]] and [[fibrosis|fibrotic]] [[Tissue (biology)|tissues]] as well as [[Callus|calluses]].<ref name="pmid10480782">{{cite journal| author=American Diabetes Association| title=Consensus Development Conference on Diabetic Foot Wound Care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association. | journal=Diabetes Care | year= 1999 | volume= 22 | issue= 8 | pages= 1354-60 | pmid=10480782 | doi=10.2337/diacare.22.8.1354 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10480782 }} </ref><ref name="pmid9531915">{{cite journal| author=Armstrong DG, Lavery LA| title=Diabetic foot ulcers: prevention, diagnosis and classification. | journal=Am Fam Physician | year= 1998 | volume= 57 | issue= 6 | pages= 1325-32, 1337-8 | pmid=9531915 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9531915 }} </ref> | ||
*Debridement should be done until it reaches the [[bleeding]] [[Tissue (biology)|tissue]], which is both a [[treatment]] and a [[diagnosis|diagnostic method]] to evaluate [[ulcer]] margin and [[abscess]]'s presence. | *Debridement should be done until it reaches the [[bleeding]] [[Tissue (biology)|tissue]], which is both a [[treatment]] and a [[diagnosis|diagnostic method]] to evaluate [[ulcer]] margin and [[abscess]]'s presence. | ||
*Before any [[surgery|surgical]] procedures [[perfusion]] of the involved [[Limb (anatomy)|limb]] must be checked, since proper [[perfusion]] is critical for [[wound healing|healing]].<ref name="SchaperAndros2012">{{cite journal|last1=Schaper|first1=N. C.|last2=Andros|first2=G.|last3=Apelqvist|first3=J.|last4=Bakker|first4=K.|last5=Lammer|first5=J.|last6=Lepantalo|first6=M.|last7=Mills|first7=J. L.|last8=Reekers|first8=J.|last9=Shearman|first9=C. P.|last10=Zierler|first10=R. E.|last11=Hinchliffe|first11=R. J.|title=Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot|journal=Diabetes/Metabolism Research and Reviews|volume=28|year=2012|pages=218–224|issn=15207552|doi=10.1002/dmrr.2255}}</ref> | *Before any [[surgery|surgical]] procedures, [[perfusion]] of the involved [[Limb (anatomy)|limb]] must be checked, since proper [[perfusion]] is critical for [[wound healing|healing]].<ref name="SchaperAndros2012">{{cite journal|last1=Schaper|first1=N. C.|last2=Andros|first2=G.|last3=Apelqvist|first3=J.|last4=Bakker|first4=K.|last5=Lammer|first5=J.|last6=Lepantalo|first6=M.|last7=Mills|first7=J. L.|last8=Reekers|first8=J.|last9=Shearman|first9=C. P.|last10=Zierler|first10=R. E.|last11=Hinchliffe|first11=R. J.|title=Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot|journal=Diabetes/Metabolism Research and Reviews|volume=28|year=2012|pages=218–224|issn=15207552|doi=10.1002/dmrr.2255}}</ref> | ||
*Since proper [[perfusion]] is critical for [[wound healing]], presence of any of the following is indicative for vascular intervention in [[diabetic foot]]:<ref name="LepäntaloApelqvist2011">{{cite journal|last1=Lepäntalo|first1=M.|last2=Apelqvist|first2=J.|last3=Setacci|first3=C.|last4=Ricco|first4=J.-B.|last5=de Donato|first5=G.|last6=Becker|first6=F.|last7=Robert-Ebadi|first7=H.|last8=Cao|first8=P.|last9=Eckstein|first9=H.H.|last10=De Rango|first10=P.|last11=Diehm|first11=N.|last12=Schmidli|first12=J.|last13=Teraa|first13=M.|last14=Moll|first14=F.L.|last15=Dick|first15=F.|last16=Davies|first16=A.H.|title=Chapter V: Diabetic Foot|journal=European Journal of Vascular and Endovascular Surgery|volume=42|year=2011|pages=S60–S74|issn=10785884|doi=10.1016/S1078-5884(11)60012-9}}</ref><ref name="pmid1246689">{{cite journal| author=Raines JK, Darling RC, Buth J, Brewster DC, Austen WG| title=Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. | journal=Surgery | year= 1976 | volume= 79 | issue= 1 | pages= 21-9 | pmid=1246689 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1246689 }} </ref> | *Since proper [[perfusion]] is critical for [[wound healing]], presence of any of the following is indicative for vascular intervention in [[diabetic foot]]:<ref name="LepäntaloApelqvist2011">{{cite journal|last1=Lepäntalo|first1=M.|last2=Apelqvist|first2=J.|last3=Setacci|first3=C.|last4=Ricco|first4=J.-B.|last5=de Donato|first5=G.|last6=Becker|first6=F.|last7=Robert-Ebadi|first7=H.|last8=Cao|first8=P.|last9=Eckstein|first9=H.H.|last10=De Rango|first10=P.|last11=Diehm|first11=N.|last12=Schmidli|first12=J.|last13=Teraa|first13=M.|last14=Moll|first14=F.L.|last15=Dick|first15=F.|last16=Davies|first16=A.H.|title=Chapter V: Diabetic Foot|journal=European Journal of Vascular and Endovascular Surgery|volume=42|year=2011|pages=S60–S74|issn=10785884|doi=10.1016/S1078-5884(11)60012-9}}</ref><ref name="pmid1246689">{{cite journal| author=Raines JK, Darling RC, Buth J, Brewster DC, Austen WG| title=Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. | journal=Surgery | year= 1976 | volume= 79 | issue= 1 | pages= 21-9 | pmid=1246689 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1246689 }} </ref> | ||
**[[Ankle]] [[pressure]] less than 80 mmHg | **[[Ankle]] [[pressure]] less than 80 mmHg | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category: | [[Category:Up-to-date]] | ||
Latest revision as of 14:14, 30 September 2021
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Diabetic foot surgery On the Web |
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American Roentgen Ray Society Images of Diabetic foot surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
One of the centerpieces of diabetic foot treatment is debridement of necrotic and fibrotic tissues as well as calluses. Debridement should be done until it reaches the bleeding tissue, which is both a treatment and a diagnostic method to evaluate ulcer margin and abscess's presence.
Surgery
- One of the centerpieces of diabetic foot treatment is debridement of necrotic and fibrotic tissues as well as calluses.[1][2]
- Debridement should be done until it reaches the bleeding tissue, which is both a treatment and a diagnostic method to evaluate ulcer margin and abscess's presence.
- Before any surgical procedures, perfusion of the involved limb must be checked, since proper perfusion is critical for healing.[3]
- Since proper perfusion is critical for wound healing, presence of any of the following is indicative for vascular intervention in diabetic foot:[4][5]
References
- ↑ American Diabetes Association (1999). "Consensus Development Conference on Diabetic Foot Wound Care: 7-8 April 1999, Boston, Massachusetts. American Diabetes Association". Diabetes Care. 22 (8): 1354–60. doi:10.2337/diacare.22.8.1354. PMID 10480782.
- ↑ Armstrong DG, Lavery LA (1998). "Diabetic foot ulcers: prevention, diagnosis and classification". Am Fam Physician. 57 (6): 1325–32, 1337–8. PMID 9531915.
- ↑ Schaper, N. C.; Andros, G.; Apelqvist, J.; Bakker, K.; Lammer, J.; Lepantalo, M.; Mills, J. L.; Reekers, J.; Shearman, C. P.; Zierler, R. E.; Hinchliffe, R. J. (2012). "Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot". Diabetes/Metabolism Research and Reviews. 28: 218–224. doi:10.1002/dmrr.2255. ISSN 1520-7552.
- ↑ Lepäntalo, M.; Apelqvist, J.; Setacci, C.; Ricco, J.-B.; de Donato, G.; Becker, F.; Robert-Ebadi, H.; Cao, P.; Eckstein, H.H.; De Rango, P.; Diehm, N.; Schmidli, J.; Teraa, M.; Moll, F.L.; Dick, F.; Davies, A.H. (2011). "Chapter V: Diabetic Foot". European Journal of Vascular and Endovascular Surgery. 42: S60–S74. doi:10.1016/S1078-5884(11)60012-9. ISSN 1078-5884.
- ↑ Raines JK, Darling RC, Buth J, Brewster DC, Austen WG (1976). "Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities". Surgery. 79 (1): 21–9. PMID 1246689.