Sökning: onr:"swepub:oai:lup.lub.lu.se:fe474568-3662-4f0c-8359-2e6d77e80c41" > Diabetic Foot
Fältnamn | Indikatorer | Metadata |
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000 | 04412naa a2200541 4500 | |
001 | oai:lup.lub.lu.se:fe474568-3662-4f0c-8359-2e6d77e80c41 | |
003 | SwePub | |
008 | 160401s2011 | |||||||||||000 ||eng| | |
024 | 7 | a https://lup.lub.lu.se/record/23484582 URI |
024 | 7 | a https://doi.org/10.1016/S1078-5884(11)60012-92 DOI |
040 | a (SwePub)lu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a art2 swepub-publicationtype |
072 | 7 | a ref2 swepub-contenttype |
100 | 1 | a Lepantalo, M.4 aut |
245 | 1 0 | a Diabetic Foot |
264 | 1 | c 2011 |
520 | a Ulcerated diabetic foot is a complex problem. Ischaemia, neuropathy and infection are the three pathological components that lead to diabetic foot complications, and they frequently occur together as an aetiologic triad. Neuropathy and ischaemia are the initiating factors, most often together as neuroischaemia, whereas infection is mostly a consequence. The role of peripheral arterial disease in diabetic foot has long been underestimated as typical ischaemic symptoms are less frequent in diabetics with ischaemia than in non-diabetics. Furthermore, the healing of a neuroischaemic ulcer is hampered by microvascular dysfunction. Therefore, the threshold for revascularising neuroischaemic ulcers should be lower than that for purely ischaemic ulcers. Previous guidelines have largely ignored these specific demands related to ulcerated neuroischaemic diabetic feet. Any diabetic foot ulcer should always be considered to have vascular impairment unless otherwise proven. Early referral, non-invasive vascular testing, imaging and intervention are crucial to improve diabetic foot ulcer healing and to prevent amputation. Timing is essential, as the window of opportunity to heal the ulcer and save the leg is easily missed. This chapter underlines the paucity of data on the best way to diagnose and treat these diabetic patients. Most of the studies dealing with neuroischaemic diabetic feet are not comparable in terms of patient populations, interventions or outcome. Therefore, there is an urgent need for a paradigm shift in diabetic foot care; that is, a new approach and classification of diabetics with vascular impairment in regard to clinical practice and research. A multidisciplinary approach needs to implemented systematically with a vascular surgeon as an integrated member. New strategies must be developed and implemented for diabetic foot patients with vascular impairment, to improve healing, to speed up healing rate and to avoid amputation, irrespective of the intervention technology chosen. Focused studies on the value of predictive tests, new treatment modalities as well as selective and targeted strategies are needed. As specific data on ulcerated neuroischaemic diabetic feet are scarce, recommendations are often of low grade. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng |
653 | a Diabetic foot | |
653 | a Ischaemia | |
653 | a Neuroischaemia | |
653 | a Vascular impairment | |
653 | a Ulcer | |
653 | a healing | |
653 | a Revascularisation | |
700 | 1 | a Apelqvist, Janu Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups4 aut0 (Swepub:lu)endo-jap |
700 | 1 | a Setacci, C.4 aut |
700 | 1 | a Ricco, J. -B.4 aut |
700 | 1 | a de Donato, G.4 aut |
700 | 1 | a Becker, F.4 aut |
700 | 1 | a Robert-Ebadi, H.4 aut |
700 | 1 | a Cao, P.4 aut |
700 | 1 | a Eckstein, H. H.4 aut |
700 | 1 | a De Rango, P.4 aut |
700 | 1 | a Diehm, N.4 aut |
700 | 1 | a Schmidli, J.4 aut |
700 | 1 | a Teraa, M.4 aut |
700 | 1 | a Moll, F. L.4 aut |
700 | 1 | a Dick, F.4 aut |
700 | 1 | a Davies, A. H.4 aut |
710 | 2 | a Genomik, diabetes och endokrinologib Forskargrupper vid Lunds universitet4 org |
773 | 0 | t European Journal of Vascular and Endovascular Surgeryg 42:Suppl. 2, s. 60-74q 42:Suppl. 2<60-74x 1532-2165 |
856 | 4 | u http://dx.doi.org/10.1016/S1078-5884(11)60012-9y FULLTEXT |
856 | 4 8 | u https://lup.lub.lu.se/record/2348458 |
856 | 4 8 | u https://doi.org/10.1016/S1078-5884(11)60012-9 |
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