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==Overview== | ==Overview== | ||
Revision as of 21:26, 5 May 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Daniel A. Gerber, M.D. [2]
Overview
The association between diabetes and foot ulceration and infection dates back to the 1850s. Significant breakthroughs in the management of diabetic foot wounds include the introduction of surgical debridement in the early 1900s, the discovery of penicillin in 1928, and advances in surgical revascularization and angioplasty. These remain mainstays of diabetic foot management, per 2004 and 2012 IDSA guidelines.
Historical Perspective
Marchal de Calvi and Thomas Hodgkin first identified an association between diabetes and foot ulceration and infection, a significant source of morbidity and mortality for these patients, in the 1850s. All skin ulcers at that time were treated with prolonged bedrest, however these lesions returned soon after mobilization. At the turn of the 19th century, Frederick Treves introduced surgical debridement of these wounds as well as modified footwear to more evenly distribute pressure across the heal. A significant breakthrough occured in 1928, when Scottish scientist Alexander Fleming discovered penicillin, further reducing mortality and need for major amputation from diabetic foot infections by nearly 50%.[1][2] Throughout the 20th century, advances in surgical limb revascularization and the advent of angioplasty drastically reduced the need for amputation and remain a mainstay of treatment.[3][4]
In 2004, the Infectious Disease Society of America published initial clinical practice guideline for the diagnosis and treatment of diabetic foot infections and, with recent updates in 2012, provide up-to-date diagnostic and therapeutic information to clinicians.[5]
References
- ↑ McKittrick LS (1946). "Recent advances in the care of the surgical complications of diabetes mellitus". N Engl J Med. 235 (26): 929–32. Text "pmid 20277657" ignored (help)
- ↑ McKittrick LS, McKittrick JB, Risley TS (1949). "Transmetatarsal amputation for the infection or gangrene in patients with diabetes mellitus". Ann Surg. 130 (4): 826–40. Text "pmid 17859470" ignored (help)
- ↑ Sanders LJ, Robbins JM, Edmonds ME (2010). "History of the team approach to amputation prevention: pioneers and milestones". J Vasc Surg. 52 (3): 3–16. Text "pmid 20804927 " ignored (help)
- ↑ LoGerfo FW, Gibbons GW, Pomposelli FB Jr, Campbell DR, Miller A, Freeman DV, Quist WC (1992). "Trends in the care of the diabetic foot. Expanded role of arterial reconstruction". Arch Surg. 127 (5): 617–620. Text "pmid 1575632" ignored (help)
- ↑ Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG, Embil JM, Joseph WS, Karchmer AW, Pinzur MS, Senneville E, Infectious Diseases Society of America (2012). "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections". Clin Infect Dis. 54 (12): e132. Text "pmid 16822461" ignored (help)