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Der diabetische Fuß

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Evidenzbasierte Gefäßchirurgie

Zusammenfassung

Patienten mit diabetischem Fuß und PAVK können sowohl endovaskulär als auch offen revaskularisiert werden, evidenzbasierte Empfehlungen, welchem Verfahren der Vorzug zu geben ist, sind nicht möglich. Die Wahl des Revaskularisationsverfahrens hängt von der Komorbidität des Patienten, der Schwere und dem Ausmaß der arteriellen Läsionen sowie von der Expertise des Zentrums ab. Bei diabetischer Fußosteomyelitis können sowohl eine primär chirurgische als auch primär medikamentöse Behandlungsstrategie erwogen werden.

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Literatur

  • Ballotta E, Toniato A, Piatto G, Mazzalai F, Da Giau G (2014) Lower extremity arterial reconstruction for critical limb ischemia in diabetes. J Vasc Surg 59: 708–719

    Article  PubMed  Google Scholar 

  • Baltodano PA, Basdag B, Bailey CR et al (2013) The positive effect of neurolysis on diabetic patients with compressed nerves of the lower extremities: a systematic review and meta-analysis. Plast Reconstr Surg Glob Open 1: e24

    Article  PubMed Central  PubMed  Google Scholar 

  • Bhamidipaty V, Dean A, Yap SL, Firth J, Barron M, Allard B, Chan ST (2015) Second toe systolic pressure measurements are valid substitutes for first toe systolic pressure measurements in diabetic patients: a prospective study. Eur J Vasc Endovasc 49: 77–82

    Article  Google Scholar 

  • Brownrigg JR, Griffin M, Hughes CO, Jones KG, Patel N, Thompson MM, Hinchliffe RJ (2014) Influence of foot ulceration on cause-specific mortality in patients with diabetes mellitus. J Vasc Surg 60: 982–986

    Article  PubMed  Google Scholar 

  • Canadian Agency for Drugs and Technologies in Health (2014) Negative pressure wound therapy for managing diabetic foot ulcers: a review of the clinical effectiveness, cost-effectiveness, and guidelines. Rapid response report: summary with critical appraisal. Ottawa (ON)

    Google Scholar 

  • Cruciani M, Lipsky BA, Mengoli C, de Lalla F (2013) Granulocyte-colony stimulating factors as adjunctive therapy for diabetic foot infections. Cochrane Database Syst Rev: CD006810

    Google Scholar 

  • Cull DL, Manos G, Hartley MC, Taylor SM, Langan EM, Eidt JF, Johnson BL (2014) An early validation of the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. J Vasc Surg; 60: 1535–1542

    Article  PubMed  Google Scholar 

  • Dellon AL, Muse VL, Nickerson DS et al (2012) Prevention of ulceration, amputation, and reduction of hospitalization: outcomes of a prospective multicenter trial of tibial neurolysis in patients with diabetic neuropathy. J Reconstr Microsurg 28: 241–246

    Article  PubMed  Google Scholar 

  • Dubský M, Jirkovská A, Bem R, Fejfarová V, Skibová J, Schaper NC, Lipsky BA (2013) Risk factors for recurrence of diabetic foot ulcers: prospective follow-up analysis in the Eurodiale subgroup. Int Wound J 10: 555–561

    Article  PubMed  Google Scholar 

  • Dumville JC, Deshpande S, O‘Meara S, Speak K (2013a) Hydrocolloid dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev: CD009099

    Google Scholar 

  • Dumville JC, O'Meara S, Deshpande S, Speak K (2013b) Alginate dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev: CD009110

    Google Scholar 

  • Dumville JC, Deshpande S, O‘Meara S, Speak K (2013c) Foam dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev: CD009111

    Google Scholar 

  • Dumville JC, Hinchliffe RJ, Cullum N, Game F, Stubbs N, Sweeting M, Peinemann F (2013d) Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus. Cochrane Database Syst Rev: CD010318

    Google Scholar 

  • Fossaceca R, Guzzardi G, Cerini P et al (2013) Endovascular treatment of diabetic foot in a selected population of patients with below-the-knee disease: is the angiosome model effective? Cardiovasc Intervent Radiol 36: 637–644

    Article  PubMed  Google Scholar 

  • Gardner SE, Haleem A, Jao YL et al (2014) Cultures of diabetic foot ulcers without clinical signs of infection do not predict outcomes. Diabetes Care 37: 2693–2701

    Article  PubMed  Google Scholar 

  • Hicks CW, Selvarajah S, Mathioudakis N, Perler BA, Freischlag JA, Black JH 3rd, Abularrage CJ (2014) Trends and determinants of costs associated with the inpatient care of diabetic foot ulcers. J Vasc Surg 60: 1247–1254

    Article  PubMed  Google Scholar 

  • Hinchliffe RJ, Andros G, Apelqvist J et al (2012) A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes Metab Res Rev 28 (Suppl 1): 179–217

    Article  PubMed  Google Scholar 

  • Hoffmann F, Claessen H, Morbach S, Waldeyer R, Glaeske G, Icks A (2013) Impact of diabetes on costs before and after major lower extremity amputations in Germany. J Diabetes Complications 27: 467–472

    Article  PubMed  Google Scholar 

  • Kennon B, Leese GP, Cochrane L et al (2012) Reduced incidence of lower-extremity amputations in people with diabetes in Scotland: a nationwide study. Diabetes Care 35: 2588–2590

    Article  PubMed Central  PubMed  Google Scholar 

  • Kranke P, Bennett MH, Martyn-St James M, Schnabel A, Debus SE (2012) Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev: CD004123

    Google Scholar 

  • Lepäntalo M, Apelqvist J, Setacci C et al (2011) Chapter V: Diabetic foot. Eur J Vasc Endovasc Surg 42 (Suppl 2): S60–S74

    Article  PubMed  Google Scholar 

  • Lipsky BA, Berendt AR, Cornia PB et al (2012) 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis 54: e132–173

    Article  PubMed  Google Scholar 

  • Lombardo FL, Maggini M, De Bellis A, Seghieri G, Anichini R (2014) Lower extremity amputations in persons with and without diabetes in Italy: 2001–2010. PLoS One 9: e86405

    Article  PubMed Central  PubMed  Google Scholar 

  • Macaré van Maurik JF, van Hal M, van Eijk RP, Kon M, Peters EJ (2014) Value of surgical decompression of compressed nerves in the lower extremity in patients with painful diabetic neuropathy: a randomized controlled trial. Plast Reconstr Surg 134: 325–332

    Article  PubMed  Google Scholar 

  • Macaré van Maurik JF, Ter Horst B, van Hal M, Kon M, Peters EJ (2014) Effect of surgical decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on stability: A randomized controlled trial. Clin Rehabil. pii: 0269215514556298. [Epub ahead of print]

    Google Scholar 

  • Martins-Mendes D, Monteiro-Soares M, Boyko EJ, Ribeiro M, Barata P, Lima J, Soares R (2014) The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complications 28: 632–638

    Article  PubMed  Google Scholar 

  • Mills JL, Conte MS, Armstrong DG, Pomposelli FB, Schanzer A, Sidawy AN, Andros G; Society for Vascular Surgery Lower Extremity Guidelines Committee (2014) The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 59: 220–234

    Article  PubMed  Google Scholar 

  • Morbach S, Furchert H, Gröblinghoff U et al (2012) Long-term prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade. Diabetes Care 35: 2021–2027

    Article  PubMed Central  PubMed  Google Scholar 

  • Nickerson DS, Rader AJ (2014) Nerve decompression after diabetic foot ulceration may protect against recurrence: a 3-year controlled, prospective analysis. J Am Podiatr Med Assoc 104: 66–70

    Article  PubMed  Google Scholar 

  • O‘Reilly D, Pasricha A, Campbell K, Burke N, Assasi N, Bowen JM, Tarride JE, Goeree R (2013) Hyperbaric oxygen therapy for diabetic ulcers: systematic review and meta-analysis. Int J Technol Assess Health Care 29: 269–281

    Article  PubMed  Google Scholar 

  • Pence LM, Mock CM, Kays MB, Damer KM, Muloma EW, Erdman SM (2014) Correlation of adherence to the 2012 Infectious Diseases Society of America practice guidelines with patient outcomes in the treatment of diabetic foot infections in an outpatient parenteral antimicrobial programme. Diabet Med 31: 1114–1120

    Article  CAS  PubMed  Google Scholar 

  • Pickwell KM, Siersma VD, Kars M, Holstein PE, Schaper NC; Eurodiale consortium (2013) Diabetic foot disease: impact of ulcer location on ulcer healing. Diabetes Metab Res Rev 29: 377–383

    Article  PubMed  Google Scholar 

  • Pscherer S, Dippel FW, Lauterbach S, Kostev K (2012) Amputation rate and risk factors in type 2 patients with diabetic foot syndrome under real-life conditions in Germany. Prim Care Diabetes 6: 241–246

    Article  PubMed  Google Scholar 

  • Seidel D, Mathes T, Lefering R, Storck M, Lawall H, Neugebauer EA (2014) Negative pressure wound therapy versus standard wound care in chronic diabetic foot wounds: study protocol for a randomized controlled trial. Trials 15: 334

    Article  PubMed Central  PubMed  Google Scholar 

  • Skrepnek GH, Armstrong DG, Mills JL (2014) Open bypass and endovascular procedures among diabetic foot ulcer cases in the United States from 2001 to 2010. J Vasc Surg 60: 1255–1265

    Article  PubMed  Google Scholar 

  • Söderström M, Albäck A, Biancari F, Lappalainen K, Lepäntalo M, Venermo M (2013) Angiosome-targeted infrapopliteal endovascular revascularization for treatment of diabetic foot ulcers. J Vasc Surg 57: 427–435

    Article  PubMed  Google Scholar 

  • Stoekenbroek RM, Santema TB, Legemate DA, Ubbink DT, van den Brink A, Koelemay MJ (2014) Hyperbaric oxygen for the treatment of diabetic foot ulcers: a systematic review. Eur J Vasc Endovasc Surg 47: 647–655

    Article  CAS  PubMed  Google Scholar 

  • Stoekenbroek RM, Santema TB, Koelemay MJ, van Hulst RA, Legemate DA, Reekers JA, Ubbink DT (2015). Is additional hyperbaric oxygen therapy cost-effective for treating ischemic diabetic ulcers? Study protocol for the Dutch DAMOCLES multicenter randomized clinical trial. J Diabetes 7: 125–132

    Article  PubMed  Google Scholar 

  • Tone A, Nguyen S, Devemy F et al (2015) Six- versus twelve-week antibiotic therapy for nonsurgically treated diabetic foot osteomyelitis: a multicenter open-label controlled randomized study. Diabetes Care 38: 302–307

    Article  PubMed  Google Scholar 

  • Tsapas A, Liakos A, Paschos P, Karagiannis T, Bekiari E, Tentolouris N, Boura P (2014) A simple plaster for screening for diabetic neuropathy: a diagnostic test accuracy systematic review and meta-analysis. Metabolism 63: 584–592

    Article  CAS  PubMed  Google Scholar 

  • Winell K, Venermo M, Ikonen T, Sund R (2013) Indicators for comparing the incidence of diabetic amputations: a nationwide population-based register study. Eur J Vasc Endovasc Surg 46: 569–574

    Article  CAS  PubMed  Google Scholar 

  • Won SH, Chung CY, Park MS, Lee T, Sung KH, Lee SY, Kim TG, Lee KM (2014) Risk factors associated with amputation-free survival in patient with diabetic foot ulcers. Yonsei Med J 55: 1373–1378

    Article  PubMed Central  PubMed  Google Scholar 

  • Wong KL, Nather A, Liang S, Chang Z, Wong TT, Lim CT (2013) Clinical outcomes of below knee amputations in diabetic foot patients. Ann Acad Med Singapore 42: 388–394

    PubMed  Google Scholar 

  • Zhang J, Hu ZC, Chen D, Guo D, Zhu JY, Tang B (2014) Effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers: a meta-analysis. Plast Reconstr Surg 134: 141–151

    Article  CAS  PubMed  Google Scholar 

  • Ziegler D, Papanas N, Rathmann W, Heier M, Scheer M, Meisinger C; KORA Study Group (2012) Evaluation of the Neuropad sudomotor function test as a screening tool for polyneuropathy in the elderly population with diabetes and pre-diabetes: the KORA F4 survey. Diabetes Metab Res Rev 28: 692–697

    Article  Google Scholar 

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Correspondence to E. Sebastian Debus .

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Debus, E., Grundmann, R. (2015). Der diabetische Fuß. In: Evidenzbasierte Gefäßchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47167-8_13

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  • DOI: https://doi.org/10.1007/978-3-662-47167-8_13

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