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2015 | OriginalPaper | Buchkapitel

1. Pathogenese, Epidemiologie und Klassifikation des diabetischen Fußsyndroms

verfasst von : Dr. med. S. Morbach, Prof. Dr. med. G. Rümenapf, Prof. Dr. med. R. Lobmann

Erschienen in: Der diabetische Fuß

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Das diabetische Fußsyndrom ist weltweit eine der bedeutendsten Komplikationen und häufigste Ursache für die Notwendigkeit einer Krankenhausbehandlung bei Patienten mit einem Diabetes mellitus. Die Ätiologie des diabetischen Fußsyndroms ist multifaktoriell und komplex. Die Pathophysiologie der diabetischen Fußläsion mit Polyneuropathie und Angiopathie sowie Wundheilungsstörungen aufgrund des Diabetes stehen hier im Vordergrund. Zur genaueren Beschreibung des diabetischen Fußsyndroms und zur Ableitung von Handlungsempfehlungen wurden unterschiedlichste Klassifikationen entwickelt. Gebräuchlich sind die Wagner- und die Armstrong-Klassifikation. Durch geeignete Behandlungsstrategien sowie interdisziplinäre und Sektoren übergreifende Strukturen ist es möglich, die vergleichsweise hohen Amputationsraten zu senken.

Abbott CA, Carrington AL, Ashe H et al. (2002) The North-WestDiabetes Foot Care Study: incidence of, and risk factorsfor, new Diabetic foot ulceration in a community-basedpatient cohort. Diabet Med 19: 377–384CrossRef

Abbott CA, Vileikyte L, Williamson S, Carrington AL, BoultonAJ (1998) Multicenter study of the incidence of andpredictive risk factors for Diabetic neuropathic footulceration. Diabetes Care 21: 1071–1075CrossRef

Adler A (2001) Risk factors for Diabetic neuropathy and footulceration. CurrDiab Rep 1:202–207

Ahroni JH, Boyko EJ, Forsberg RC (1999) Clinical correlates ofplantar pressure among Diabetic veterans. Diabetes Care22: 965–972

Akbari CM, LoGerfo FW (1999) Diabetes and peripheral vasculardisease. J VascSurg 30: 373–384

Akbari CM, Gibbons GW, Habershaw GM, LoGerfo FW, Veves A (1997) The effect of arterial reconstruction on the naturalhistory of diabetic neuropathy. Arch Surg 132: 148–152CrossRef

American Diabetes Association (1999) Consensus DevelopmentConference on Diabetic Foot Wound Care. 7.-8. April 1999, Boston, Massachusetts. J Am Podiatr MedAssoc 89: 475–483

American Diabetes Association (2003) Peripheral arterialdisease in people with Diabetes. Diabetes Care 26:3333–3341CrossRef

Apelqvist J, Larsson J, Agardh CD (1993) Long-term prognosisfor Diabetic patients with foot ulcers. J Intern Med 233:485–491CrossRef

Armstrong DG, Lavery LA, Harkless LB (1998) Validation of aDiabetic wound classification system. The contribution ofdepth, infection, and ischemia to risk of amputation. Diabetes Care 21: 855–859CrossRef

Armstrong DG, Lavery LA, Harkless LB (1998) Who is at risk forDiabetic foot ulceration? ClinPodiatr Med Surg 15: 11–19

Armstrong DG, Mills JL (2013) Toward a change in syntax indiabetic foot care: prevention equals remission. J AmPodiatr Med Assoc 103: 161–162

Arora S, Logerfo FW (1997) Lower extremity macrovasculardisease in Diabetes. J Am Podiatr Med Assoc 87: 327–331CrossRef

Arora S, Pomposelli F, Logerfo FW, Veves A (2002) Cutaneousmicrocirculation in the neuropathic Diabetic foot improvessignificantly but not completely after successfullower extremity revascularization. J VascSurg 35: 501–505

Arts ML, de Haart M, Bus SA, Bakker JP, Hacking HG, et al. (2014) Perceived usability and use of custom-madefootwear in diabetic patients at high risk for foot ulceration.J Rehabil Med 46(4):357–62CrossRefPubMed

Basit A, Hydrie MZ, Hakeem R., Ahmedani MY, Masood Q(2004): Frequency of chronic complications of type IIDiabetes. J Coll Physicians Surg Pak 14: 79–83

Berendt AR, Peters EJ, Bakker K, Embil JM, Eneroth M, et al. (2008) Diabetic foot osteomyelitis: a progress report ondiagnosis and a systematic review of treatment. DiabetesMetab Res Rev 24 Suppl 1: S145–161

Boulton AJ (2000) The Diabetic foot: a global view. DiabetesMetab Res Rev 16 Suppl 1: S2–S5

Boulton AJ, Meneses P, Ennis WJ (1999) Diabetic foot ulcers:A framework for prevention and care. Wound RepairRegen 7: 7–16

Boulton AJ, Valensi P, Tesfaye S (2011) The Diabetic Neuropathies:Reports from the Diabetic Neuropathy ExpertPanel Meeting on Neuropathy, Toronto, October 2009:Introduction. Diabetes Metab Res Rev [Epub ahead ofprint]

Bowering CK (2001) Diabetic foot ulcers.Pathophysiology,assessment, and therapy. Can Fam Physician 47: 1007–1016PubMedCentral

Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ (2006) Prediction of diabetic foot ulcer occurrence using commonlyavailable clinical information: the Seattle DiabeticFoot Study. Diabetes Care 29: 1202–1207

Boyko EJ, Ahroni JH, Stensel V et al. (1999) A prospectivestudy of risk factors for Diabetic foot ulcer. The SeattleDiabetic Foot Study. Diabetes Care 22: 1036–1042CrossRef

Burns SL, Leese GP, McMurdo ME (2002) Older people and illfitting shoes. Postgrad Med J 78: 344–346CrossRefPubMedCentral

Caselli A, Pham H, Giurini JM., Armstrong DG, Veves A (2002) The forefoot-to-rearfoot plantar pressure ratio is increasedin severe Diabetic neuropathy and can predictfoot ulceration. Diabetes Care 25: 1066–1071CrossRef

Chantelau E, Ibeling M (1992) [There is no occluding microangiopathyin diabetic foot]. Vasa Suppl 35: 27–28

Chantelau E, Lee KM, Jungblut R (1995) Association of belowkneeatherosclerosis to medial arterial calcification indiabetes mellitus. Diabetes Res ClinPract 29: 169–172

Day MR, Harkless LB (1997) Factors associated with pedalulceration in patients with Diabetes mellitus.J Am Podiatr Med Assoc 87: 365–369

Delbridge L, Ctercteko G, Fowler C, Reeve TS, Le Quesne LP (1985) The aetiology of Diabetic neuropathic ulcerationof the foot. Br J Surg 72: 1–6PubMed

Diabetes care and research group in Europe (1990) The SaintVincent Declaration. Diabet Med 7: 36–0

Dyck P, Karnes JL, O’Brien P et al. (1992) The Rochester DiabeticNeuropathy Study: Reassessment of tests andcriteria for diagnosis and staged severity. Neurology 42:1164–1170

Faglia E, Clerici G, Caminiti M, Curci C, Morabito A, et al. (2013) B-Type Natriuretic Peptide Predict Mortality in DiabeticPatients with Foot Ulcer. J Res Diabetes. DOI:10.5171/2013.388970

Faglia E, Favales F, Morabito A (2001) New ulceration, newmajor amputation, and survival rates in Diabetic subjectshospitalized for foot ulceration from 1990 to 1993:a 6.5-year follow-up. Diabetes Care 24: 78–83CrossRefPubMed

Forst T, Kann P, Pfuetzner A et al. (1994) Association between≫Diabetic thick skin syndrome≪ and neurological disordersin Diabetes mellitus. ActaDiabetol 31: 73–77

Forst T, Pfuetzner A, Kann P et al. (1995) Association betweenDiabetic-autonomic-C-fibre-neuropathy and medial wallcalcification and the significance in the outcome of trophicfoot lesions. ExpClinEndocrinol Diabetes 103: 94–98

Forst T, Pfutzner A (2004) Risikofaktor fur das DiabetischeFussyndrom: AutonomeDysfunktionan der unterenExtremitat. MMW Fortschr Med 146: 35–38

Frykberg RG, Arora S, Pomposelli FB Jr, LoGerfo F (1998) Functional outcome in the elderly following lowerextremity amputation. J Foot Ankle Surg 37: 181–185

Frykberg RG, Lavery LA, Pham H et al. (1998) Role of neuropathyand high foot pressures in Diabetic foot ulceration. Diabetes Care 21: 1714–1719CrossRef

Gilmore JE, Allen JA, Hayes JR (1993) Autonomic function inneuropathic Diabetes patients with foot ulceration. Diabetes Care 16/1: 61–67

Girod I, Valensi P, Laforet C et al. (2003) An economic evaluationof the cost of Diabetic foot ulcers: results of a retrospectivestudy on 239 patients. Diabetes Metab 29:269–277CrossRef

Gonzalez JS, Hardman MJ, Boulton AJ, Vileikyte L (2011) Coping and depression in diabetic foot ulcer healing:causal influence, mechanistic evidence or none of theabove? Diabetologia 54: 205–206CrossRef

Gonzalez JS, Vileikyte L, Ulbrecht JS, Rubin RR, Garrow AP, etal. (2010) Depression predicts first but not recurrentdiabetic foot ulcers. Diabetologia 53: 2241–2248CrossRef

Harrington C, Zagari MJ, Corea J, Klitenic J (2000) A costanalysis of Diabetic lower-extremity ulcers. Diabetes Care23: 1333–1338

Heller G, Gunster C, Schellschmidt H (2004) WiehaufigsindDiabetes-bedingteAmputationen der unterenExtremitatin Deutschland? Dtsch Med Wochenschr 129: 429–433CrossRef

Hile C, Veves A (2003) Diabetic neuropathy and microcirculation. CurrDiab Rep 3: 446–451

Holzer SE, Camerota A, Martens L et al. (1998) Costs andduration of care for lower extremity ulcers in patientswith Diabetes. ClinTher 20: 169–181

Icks A, Haastert B, Trautner C, Giani G, Glaeske G, et al. (2009) Incidence of lower-limb amputations in the diabeticcompared to the non-diabetic population. findings fromnationwide insurance data, Germany, 2005-2007. ExpClin Endocrinol Diabetes 117: 500–504

Icks A, Scheer M, Morbach S, Genz J, Haastert B, et al. (2011) Time-dependent impact of diabetes on mortality inpatients after major lower extremity amputation: survivalin a population-based 5-year cohort in Germany. Diabetes Care 34: 1350–1354

Izumi Y, Satterfield K, Lee S, Harkless LB (2006) Risk of reamputationin diabetic patients stratified by limb and level ofamputation: a 10-year observation. Diabetes Care 29:566–570CrossRef

Ismail K, Winkley K, Stahl D, Chalder T, Edmonds M (2007) Acohort study of people with diabetes and their first footulcer: the role of depression on mortality. Diabetes Care30: 1473–1479

Iversen MM, Tell GS, Riise T, Hanestad BR, Ostbye T, et al. (2009) History of foot ulcer increases mortality amongindividuals with diabetes: ten-year follow-up of theNord-Trondelag Health Study, Norway. Diabetes Care 32:2193–2199CrossRefPubMedCentral

Jeffcoate WJ, Price PE, Phillips CJ, Game FL, Mudge E, et al. (2009) Randomised controlled trial of the use of threedressing preparations in the management of chroniculceration of the foot in diabetes. Health Technol Assess13: 1-86, iii–iv

Jorneskog G, Brismar K, Fagrell B (1995) Skin capillary circulationis more impaired in the toes of diabetic than nondiabeticpatients with peripheral vascular disease. DiabetMed 12: 36–41

Jorneskog G (2012) Why critical limb ischemia criteria are notapplicable to diabetic foot and what the consequencesare. Scand J Surg 101: 114–118CrossRef

Kalani M, Brismar K, Fagrell B, Ostergren J, Jorneskog G (1999) Transcutaneous oxygen tension and toe blood pressureas predictors for outcome of Diabetic foot ulcers. DiabetesCare 22: 147–151

Kraus O, Neufang A, Eckardt A et al. (2002) InterdisziplinareDiagnostik und Therapie des ischamisch-osteomyelitischenDiabetischenFussyndroms. Med Klin 97: 244–255CrossRef

Larsson J, Agardh CD, Apelqvist J, Stenstrom A (1998) Longtermprognosis after healed amputation in patients withDiabetes.ClinOrthop 350: 149–158

Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, FleischliJG (1998) Practical criteria for screening patients at highrisk for Diabetic foot ulceration. Arch Intern Med 158:157–162CrossRef

Lavery LA, Peters EJ, Williams JR, Murdoch DP, Hudson A, et al. (2008) Reevaluating the way we classify the diabetic foot:restructuring the diabetic foot risk classification systemof the International Working Group on the Diabetic Foot.Diabetes Care 31: 154–156

Lavery LA, van Houtum WH, Harkless LB (1996) In-hospitalmortality and disposition of Diabetic amputees in TheNetherlands.Diabet Med 13: 192–197CrossRef

Lepantalo M, Apelqvist J, Setacci C, Ricco JB, de Donato G, etal. (2011) Chapter V: Diabetic foot. Eur J VascEndovascSurg 42 Suppl 2: S60–74

Lepantalo M (2012) The path from art to evidence in treatingcritical limb ischaemia - reflections on 35 years' experience. Scand J Surg 101: 78–85CrossRefPubMed

Liebl A, Neiss A, Spannheimer A et al (2001) Kosten des Typ-2Diabetes in Deutschland. Dtsch Med Wochenschr 126:585–589CrossRef

Litzelman DK, Marriott DJ, Vinicor F (1997) Independentphysiological predictors of foot lesions in patients withNIDDM. Diabetes Care 20: 1273–1278

Litzelman DK, Marriott DJ, Vinicor F (1997) The role of footwearin the prevention of foot lesions in patients withNIDDM. Conventional wisdom or evidence-based practice?Diabetes Care 20: 156–162

Lobmann R, Achwerdov O, Brunk-Loch S, Engels G, Trocha A, et al. (2014) The diabetic foot in Germany 2005-2012:Analysis of quality in specialized diabetic foot carecenters. Wound Medicine: 27–29

Lobmann R, Schultz G, Lehnert H (2003) MolekulareGrundlagender WundheilungbeimdiabetischenFussyndrom.Med Klin 98: 292–301CrossRef

LoGerfo FW, Gibbons GW, Pomposelli FB Jr et al. (1992) Trendsin the care of the Diabetic foot. Expanded role of arterialreconstruction. Arch Surg 127: 617–620CrossRef

Londahl M, Katzman P, Fredholm O, Nilsson A, Apelqvist J (2008) Is chronic diabetic foot ulcer an indicator ofcardiac disease? J Wound Care 17: 12–16CrossRef

Lynch SE, Colvin RB, Antoniades HN (1989) Growth factors inwound healing. Single and synergistic effects on partialthickness porcine skin wounds. Journal of Clinical Investigation84: 640–646

Macfarlane RM, Jeffcoate WJ (1997) Factors contributing tothe presentation of Diabetic foot ulcers. Diabet Med 14:867–870CrossRef

Mast BA, Schultz GS (1996) Interactions of cytokines, growthfactors and proteasesin acute and chronic wounds.Wound. Repair Regen 4: 441–420

Mayfield JA, Caps MT, Boyko EJ, Ahroni JH, Smith DG (2002) Relationship of medial arterial calcinosis to autonomicneuropathy and adverse outcomes in a Diabetic veteranpopulation. J Diabetes Complications 16: 165–171CrossRef

Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM (2003) Preventive foot care in people with Diabetes.Diabetes Care 26 Suppl 1: S78–S79

McFadden JP., Corrall RJM, O’Brien IAD (1991) Autonomic andsensory nerve function in Diabetic foot ulceration. ClinExpDermatol 16: 193–196

Meijer JW, Bosma E, Lefrandt JD et al. (2003) Clinical diagnosisof Diabetic polyneuropathy with the Diabetic neuropathysymptom and Diabetic neuropathy examinationscores. Diabetes Care 26: 697–701CrossRefPubMed

Meyer-Heintze V (1999) Der DiabetischeFusaussozialmedizinischerSichtZentralblChir 124 Suppl 1: 45–48

Mills JL, Sr., Conte MS, Armstrong DG, Pomposelli FB, SchanzerA, et al. (2013) The Society for Vascular Surgery LowerExtremity Threatened Limb Classification System: Riskstratification based on Wound, Ischemia, and foot Infection(WIfI). J Vasc Surg. DOI: 10.1016/j.jvs.2013.08.003

Morbach S, Muller E, Reike H, Risse A, Spraul M (2004) Diagnostik, Therapie, Verlaufskontrolle und Pravention desdiabetischenFussyndroms. In: ScherbaumWA, Kiess W, Landgraf R (Hrsg.) DiabetischesFussyndrom. Diabetesund Stoffwechsel 13: 9–30

Morbach S, Muller E, Reike H, Risse A, Rumenapf G, et al. (2009) Diagnostik, Therapie, Verlaufskontrolle undPravention des diabetischenFussyndroms. Diabetologieund Stoffwechsel 4: 301–325

Morbach S, Furchert H, Groblinghoff U, Hoffmeier H, KerstenK, et al. (2012) Long-term prognosis of diabetic footpatients and their limbs: amputation and death over thecourse of a decade. Diabetes Care 35: 2021–2027CrossRefPubMedCentral

Morbach S, Icks A, Rumenapf G, Armstrong DG (2013) Commenton: Bernstein. Reducing foot wounds in diabetes. Diabetes Care 36:e48, e6–2

Morris AD, McAlpine R, Steinke D et al. (1998) Diabetes andlower-limb amputations in the community.A retrospectivecohort study.DARTS/MEMO Collaboration. DiabetesAudit and Research in Tayside Scotland/Medicines MonitoringUnit Diabetes Care 21: 738–743

Moss SE, Klein R, Klein BE (1999) The 14-year incidence oflower-extremity amputations in a Diabetic population. The Wisconsin Epidemiologic Study of Diabetic RetinopathyDiabetes Care 22: 951–959

Moulik PK, Mtonga R, Gill GV (2003) Amputation and mortalityin new-onset Diabetic foot ulcers stratified by etiology. Diabetes Care 26: 491–494

Nwomeh BC, Yager DR, Cohen IK (1998) Physiology of thechronic wound. ClinPlastSurg 25: 341–356

New JP, McDowell D, Burns E, Young RJ (1998) Problem ofamputations in patients with newly diagnosed diabetesmellitus. Diabet Med 15: 760–764CrossRef

O’Brien SP, Schwedler M, Kerstein MD (1998) Peripheral neuropathiesin Diabetes. SurgClin North Am 78: 393–408

Ollendorf DA, Kotsanos JG, Wishner WJ et al. (1998) Potentialeconomic benefits of lower-extremity amputation preventionstrategies in Diabetes. Diabetes Care 21: 1240–1245CrossRef

Oyibo SO, Jude EB, Tarawneh I et al. (2001) A comparison oftwo Diabetic foot ulcer classification systems: the Wagnerand the University of Texas wound classification systems. Diabetes Care 24: 84–88CrossRef

Padberg FT, Back TL, Thompson PN, Hobson RW (1996) Transcutaneousoxygen (TcpO2) estimates probability ofhealing in the ischemic extremity. J Surg Res 60: 365–369CrossRef

Pecoraro RE, Reiber GE, Burgess EM (1990) Pathways to diabeticlimb amputation. Basis for prevention. DiabetesCare 13: 513–521

Pfutzner A, Forst T, Engelbach M et al. (2001) The influence ofisolated small nerve fibre dysfunction on microvascularcontrol in patients with Diabetes mellitus. Diabet Med 18:489–494CrossRef

Pound N, Chipchase S, Treece K, Game F, Jeffcoate W (2005) Ulcer-free survival following management of foot ulcersin diabetes. Diabet Med 22: 1306–1309CrossRef

Prompers L, Huijberts M, Apelqvist J, Jude E, Piaggesi A, et al. (2007) High prevalence of ischaemia, infection andserious comorbidity in patients with diabetic foot diseasein Europe. Baseline results from the Eurodiale study. Diabetologia 50: 18–25CrossRefPubMed

Prompers L, Huijberts M, Schaper N, Apelqvist J, Bakker K, etal. (2008) Resource utilisation and costs associated withthe treatment of diabetic foot ulcers. Prospective datafrom the Eurodiale Study.Diabetologia 51: 1826–1834

Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, et al. (2008) Prediction of outcome in individuals with diabeticfoot ulcers: focus on the differences between individualswith and without peripheral arterial disease. The EURODIALEStudy.Diabetologia 51: 747–755PubMedCentral

Reiber GE, Lipsky BA, Gibbons GW (1998) The burden ofDiabetic foot ulcers. Am J Surg 176: 5S–10SCrossRefPubMed

Reiber GE, Vileikyte L, Boyko EJ, del Aguila M, Smith DG, et al. (1999) Causal pathways for incident lower-extremityulcers in patients with diabetes from two settings. DiabetesCare 22: 157–162

Samann A, Tajiyeva O, Muller N, Tschauner T, Hoyer H, et al. (2008) Prevalence of the diabetic foot syndrome at theprimary care level in Germany: a cross-sectional study. Diabet Med 25: 557–563

Santosa F, Moysidis T, Kanya S, Babadagi-Hardt Z, Luther B, etal. (2013) Decrease in Major Amputations in Germany. IntWound J. DOI: 10.1111/iwj.12096

Schaper NC, Apelqvist J, Bakker K (2003) The internationalconsensus and practical guidelines on the managementand prevention of the Diabetic foot Curr. Diab Rep 3:475–479

Schaper NC (2004) Diabetic foot ulcer classification system forresearch purposes: a progress report on criteria for includingpatients in research studies. Diabetes Metab ResRev 20 Suppl. 1: S90–95

Schuch V, Moysidis T, Weiland D, Santosa F, Kroger K (2012) Dementia and amputation. Interv Med ApplSci 4: 175–180

Sims DS Jr, Cavanagh PR, Ulbrecht JS (1988) Risk factors in theDiabetic foot Recognition and management PhysTher68: 1887–1902

Singh N, Armstrong DG, Lipsky BA (2005) Preventing footulcers in patients with diabetes. JAMA 293: 217–228CrossRef

Sosenko JM, Sparling YH, Hu D et al. (1999) Use of theSemmes-Weinstein monofilament in the strong heartstudy. Risk factors for clinical neuropathy. Diabetes Care22: 1715–1721

Sumpio BE, Lee T, Blume PA (2003) Vascular evaluation andarterial reconstruction of the Diabetic foot ClinPodiatrMed Surg 20: 689–708

Tarnuzzer RW, MacAuley S, Bruce M et al. (1995) Epidermalgrowth factor in wound healing: A model for molecularpathogenesis of chronic wounds. Serono Symposia

Tarnuzzer RW, Schultz GS (1996) Biochemical analysis of acuteand chronic wound environments. Wound. Repair Regen4: 321–325

Trautner C, Haastert B, Giani G, Berger M (1996) Incidence oflower limb amputations and Diabetes. Diabetes Care19/9: 1006–1009

Trautner C, Haastert B, Mauckner P, Gatcke LM, Giani G (2007) Reduced incidence of lower-limb amputations in thediabetic population of a German city, 1990-2005: resultsof the Leverkusen Amputation Reduction Study (LARS).Diabetes Care 30: 2633–2637CrossRef

Trautner C, Haastert B, Spraul M, Giani G, Berger M (2001) Unchanged incidence of lower-limb amputations in aGerman City, 1990-1998. Diabetes Care 24: 855–859CrossRef

Trengove NJ, Bielefeldt-Ohmann H, Stacey MC (2000) Mitogenicactivity and cytokine levels in non-healing andhealing chronic leg ulcers. Wound Repair Regen 8: 13–25PubMed

Trengove NJ, Stacey MC, MacAuley S et al. (1999) Analysis ofthe acute and chronic wound environments: the role ofproteases and their inhibitors. Wound Repair Regen 7:442–452CrossRef

Uccioli L, Mancini L, Giordano A et al. (1992) Lower limbarterio-venous shunts, autonomic neuropathy andDiabetic foot Diabetes Res ClinPracT 16: 123–130

Van Gils CC, Wheeler, Mellstrom M et al. (1999) Amputationprevention by vascular surgery and podiatry collaborationin high-risk Diabetic and nonDiabetic patients. TheOperation Desert Foot experience. Diabetes Care 22:678–683CrossRefPubMed

Veves A, Donaghue VM, Sarnow MR, Giurini JM, Campbell DR, et al. (1996) The impact of reversal of hypoxia by revascularizationon the peripheral nerve function of diabeticpatients. Diabetologia 39: 344–348CrossRef

Veves A, Murray HJ, Young MJ, Boulton AJM (1992) The risk offoot ulceration in Diabetic patients with high foot pressure:a prospective study. Diabetologia 35: 660–663CrossRef

Wagner FW (1981) Thedysvascular foot: a system for diagnosisand treatment. Foot & Ancle 2: 64–122

Weck M, Slesaczeck T, Paetzold H, Muench D, Nanning T, et al. (2013) Structured health care for subjects with diabeticfoot ulcers results in a reduction of major amputationrates. CardiovascDiabetol 12: 4–5

Williams DR (1985) Hospital admissions of diabetic patients:information from hospital activity analysis. Diabet Med 2:27–32CrossRefPubMed

Williams LH, Rutter CM, Katon WJ, Reiber GE, Ciechanowski P, et al. (2010) Depression and incident diabetic foot ulcers:a prospective cohort study. Am J Med 123: 748–754CrossRef

Winkler AS, Ejskjaer N, Edmonds M, Watkins PJ (2000) Dissociatedsensory loss in Diabetic autonomic neuropathy. Diabet Med 17: 457–462

Yager DR, Zhang Y, Liang H-X, Diegelmann RF, Cohen IK (1996) Wound fluids from human pressure ulcers containelevated matrix metalloproteinase levels and activitycompared to surgical wound fluids. J Invest Dermatol107: 743–748

Titel: Pathogenese, Epidemiologie und Klassifikation des diabetischen Fußsyndroms
verfasst von: Dr. med. S. Morbach
Prof. Dr. med. G. Rümenapf
Prof. Dr. med. R. Lobmann
Verlag: Springer Berlin Heidelberg
Buch: Der diabetische Fuß
Print ISBN: 978-3-642-38424-0

Electronic ISBN: 978-3-642-38425-7

Copyright-Jahr: 2015
DOI: https://doi.org/10.1007/978-3-642-38425-7_1

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Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

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