Treatment of the diabetic foot - to amputate or not?
- PMID: 25344293
- PMCID: PMC4218993
- DOI: 10.1186/1471-2482-14-83
Treatment of the diabetic foot - to amputate or not?
Abstract
Background: Diabetic foot infections are a frequent clinical problem. About 50% of patients with diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches.
Discussion: The article debates the pros and cons of amputation of the diabetic foot. The thesis is that if the guidelines on the management of the diabetic foot are followed primary amputation is only necessary for the unsalvageable diabetic foot. This approach would reduce the incidence of lower limb amputations in diabetic patients.
Summary: We favour the argument that a structured clinical and vascular assessment would help clinical decision- making as to which patients to hospitalize, which to send for imaging, or for whom to recommend surgical interventions. Endovascular procedures are the future in the treatment of diabetic arterial disease and hence the diabetic foot.
Figures
Similar articles
-
Treatment of diabetic foot ulcer: an overview strategies for clinical approach.Curr Diabetes Rev. 2006 Nov;2(4):431-47. doi: 10.2174/1573399810602040431. Curr Diabetes Rev. 2006. PMID: 18220646 Review.
-
Midfoot amputations expand limb salvage rates for diabetic foot infections.Ann Vasc Surg. 2005 Nov;19(6):805-11. doi: 10.1007/s10016-005-7973-3. Ann Vasc Surg. 2005. PMID: 16205848
-
Trends in Lower Limb Amputation in Patients with Diabetic Foot Based on Vascular Intervention of Peripheral Arterial Disease in Korea: a Population-based Nationwide Study.J Korean Med Sci. 2019 Jul 8;34(26):e178. doi: 10.3346/jkms.2019.34.e178. J Korean Med Sci. 2019. PMID: 31269542 Free PMC article.
-
A retrospective analysis of amputation rates in diabetic patients: can lower extremity amputations be further prevented?Cardiovasc Diabetol. 2012 Mar 2;11:18. doi: 10.1186/1475-2840-11-18. Cardiovasc Diabetol. 2012. PMID: 22385577 Free PMC article.
-
Principles of partial foot amputations in the diabetic.Instr Course Lect. 1999;48:321-9. Instr Course Lect. 1999. PMID: 10098058 Review.
Cited by
-
Factors Influencing Wound Healing in Diabetic Foot Patients.Medicina (Kaunas). 2024 Apr 27;60(5):723. doi: 10.3390/medicina60050723. Medicina (Kaunas). 2024. PMID: 38792906 Free PMC article.
-
The Significant Association between Polymicrobial Diabetic Foot Infection and Its Severity and Outcomes.Malays J Med Sci. 2019 Jan;26(1):107-114. doi: 10.21315/mjms2019.26.1.10. Epub 2019 Feb 28. Malays J Med Sci. 2019. PMID: 30914898 Free PMC article.
-
Vanillin Enhances Photobiomodulation Wound Healing by Modulating Glyco-Oxidative Stress and Glucose Dysmetabolism in Diabetic Wounded Fibroblast Cells.J Cell Mol Med. 2025 Apr;29(7):e70537. doi: 10.1111/jcmm.70537. J Cell Mol Med. 2025. PMID: 40194982 Free PMC article.
-
Decellularized materials derived from TSP2-KO mice promote enhanced neovascularization and integration in diabetic wounds.Biomaterials. 2018 Jul;169:61-71. doi: 10.1016/j.biomaterials.2018.03.049. Epub 2018 Mar 29. Biomaterials. 2018. PMID: 29631168 Free PMC article.
-
Medial Arterial Calcification and the Risk of Amputation of Diabetic Foot Ulcer in Patients With Diabetic Kidney Disease.J Korean Med Sci. 2023 May 29;38(21):e160. doi: 10.3346/jkms.2023.38.e160. J Korean Med Sci. 2023. PMID: 37270915 Free PMC article.
References
-
- 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. Clinical practice guidelines for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54:132–73. doi: 10.1093/cid/cis346. - DOI - PubMed
-
- Becks PJ, Mackaay AJ, de Neeling JN, de Vries H, Bouter LM, Heine RJ. Peripheral arterial disease in relation to glycaemic level in an elderly Caucacianpopulation : the Hoorn study. Diabetologia. 1995;38(1):163–166. - PubMed
-
- Prompers L, Huijberts M, Apelqvist J, Jude E, Piaggesi A, Bakker K, Edmonds M, Holstein P, Jirkovska A, Mauricio D, Ragnarson Tennvall G, Reike H, Spraul M, Uccioli L, Urbancic V, Van Acker K, van Baal J, van Merode F, Schape N. High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia. 2007;50:18–25. doi: 10.1007/s00125-006-0491-1. - DOI - PubMed
Pre-publication history
-
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2482/14/83/prepub
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous