Surgical management of the diabetic foot:The current evidence  

作　　者：Richard Henry Randall Roberts Gareth Rhys Davies-Jones James Brock Vaishnav Satheesh Greg AJ Robertson 

机构地区：[1]Department of Trauma and Orthopaedics,Wrexham Maelor Hospital,Wrexham LL137TD,United Kingdom [2]Department of Trauma and Orthopaedics,The Robert Jones and Agnes Hunt Orthopaedic Hospital,Oswestry SY107AG,United Kingdom

出　　处：《World Journal of Orthopedics》2024年第5期404-417,共14页世界骨科杂志（英文版）

摘　　要：The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens globally.This review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,amputations.The escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality rates.This review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse outcomes.In addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot pathologies.The integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关 键 词：DIABETES Diabetic foot CHARCOT OSTEOMYELITIS AMPUTATION Diabetic foot attack Conservative surgery 

分 类 号：R741[医药卫生—神经病学与精神病学]