The Diabetic Foot Syndrome

Description

In recent years, "diabetic foot" has become the common name given to chronic complications of diabetes mellitus in the lower limb. This book provides an up-to-date picture of the clinical scenario, the latest understanding of the mechanisms in regard to pathology, the current standards of therapy, and the organizational tasks that a modern approach to such a complex pathology warrants. All contributors have delivered articles that are as informative and straight-to-the point as possible, including not only their own experience in the field, but also giving a wider picture to link each article to the other. The Diabetic Foot Syndrome is not only relevant to specialists, but also to all the caregivers involved in the management of the patients at risk for developing the pathology, those affected, and those who are at risk of recurrences.

Informations

• Publié par: S. Karger AG
• Date de parution: 16 novembre 2017
• Nombre de lectures: 1
• EAN13: 9783318061451
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

The Diabetic Foot Syndrome
Frontiers in Diabetes
Vol. 26
Series Editor
Massimo Porta Turin
The Diabetic Foot Syndrome
Volume Editors
Alberto Piaggesi Pisa
Jan Apelqvist Lund
36 figures, 14 in color, and 12 tables, 2018
Frontiers in Diabetes
Founded 1981 by F. Belfiore, Catania
_______________________ Alberto Piaggesi, MD Diabetic Foot Section Department of Medicine University of Pisa, Pisa, Italy
_______________________ Jan Apelqvist, MD Department of Endocrinology University Hospital of Skåne, Malmö, Sweden and Division for Clinical Sciences University of Lund, Lund, Sweden
Library of Congress Cataloging-in-Publication Data
Names: Piaggesi, Alberto, editor. | Apelqvist, Jan, editor.
Title: The diabetic foot syndrome / volume editors, Alberto Piaggesi, Jan Apelqvist.
Other titles: Frontiers in diabetes ; v. 26. 0251–5342
Description: Basel ; New York : Karger, 2017. | Series: Frontiers in diabetes, ISSN 0251–5342 ; vol. 26 | Includes bibliographical references and indexes.
Identifiers: LCCN 2017042611| ISBN 9783318061444 (alk. paper) | ISBN 9783318061451 (e-ISBN)
Subjects: | MESH: Diabetic Foot--therapy | Diabetic Foot--complications | Diabetic Foot--surgery
Classification: LCC RD781 | NLM WK 835 | DDC 617.5/85--dc23
LC record available at https://lccn.loc.gov/2017042611

Bibliographic Indices. This publication is listed in bibliographic services.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2018 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed on acid-free and non-aging paper (ISO 9706)
ISSN 0251–5342
e-ISSN 1662–2995
ISBN 978–3–318–06144–4
e-ISBN 978–3–318–06145–1
Contents
Preface
Piaggesi, A. (Pisa); Apelqvist, J. (Lund)
The Diabetic Foot Syndrome Today: A Pandemic Uprise
Apelqvist, J. (Malmö/Lund)
A Complication of the Complications: The Complexity of Pathogenesis and the Role of Co-Morbidities in the Diabetic Foot Syndrome
Meloni, M.; Izzo, V.; Giurato, L.; Uccioli, L. (Rome)
Re-Evaluating the Outcomes in Diabetic Foot Management
Clerici, G. (Bergamo/Milan); Iacopi, E. (Pisa); Caminiti, M.S.; Casini, A.;
Curci, V. (Bergamo/Milan); Faglia, E. (Salerno); Piaggesi, A. (Pisa)
The Charcot Foot Revisited: How the New Pathogenetic Findings Explain the Clinical Course of the Disease
Petrova, N.L. (London)
Diabetic Peripheral Arteriopathy: A Tale of Two Diseases
Edmonds, M.E.; Shanahan, C.; Petrova, N.L. (London)
Does Microangiopathy Contribute to the Pathogenesis of the Diabetic Foot Syndrome?
Coppelli, A.; Abbruzzese, L.; Goretti, C.; Iacopi, E.; Riitano, N.; Piaggesi, A. (Pisa)
The Organization of Care for the Diabetic Foot Syndrome: A Time-Dependent Network
Piaggesi, A.; Abbruzzese, L.; Coppelli, A.; Iacopi, E.; Riitano, N.; Goretti, C. (Pisa)
Offloading the Diabetic Foot: The Evolution of an Integrated Strategy
Bus, S.A. (Amsterdam)
Surgical Management of the Charcot Foot
Dalla Paola, L.; Scavone, G.; Carone, A.; Vasilache, L.; Boscarino, G. (Cotignola)
Indications to Revascularization in the Ischaemic Diabetic Foot
Ferraresi, R.; Losurdo, F. (Bergamo); Lorenzoni, R. (Lucca); Ferraris, M. (Legnano); Caminiti, M.S.; Casini, A. (Bergamo)
An Integrated Approach for the Effective Management of Limb-Threatening Ischaemia in the Diabetic Foot
Mills, J.L. (Houston, TX)
Resistant Infections in the Diabetic Foot: A Frightening Scenario
Tascini, C. (Napoli)
Antibacterial Treatment in Diabetic Foot Infections
Senneville, E. (Tourcoing/Lille)
The Role of Surgery in the Management of the Infected Diabetic Foot
Aragón-Sánchez, J. (Las Palmas de Gran Canaria)
Local Management of Diabetic Foot Ulcers, Dressings and Other Local Treatments
Game, F.L. (Derby)
Towards Extending Ulcer-Free Days in Remission in the Diabetic Foot Syndrome
Boghossian, J.A. (Los Angeles, CA); Miller, J.D. (Baltimore, MD);
Armstrong, D.G. (Los Angeles, CA)
Author Index
Subject Index
Preface

In recent years, the “diabetic foot” (DF), has become a common name to describe the chronic complications of diabetes mellitus in the lower limb; it has also rapidly increased its relevance among various specialties such as diabetology, podiatry, vascular surgery, interventional cardiology and radiology, infectious diseases, orthopaedic surgery and others that are involved in its management both from a clinical and a scientific point of view: in 1971, 15 papers were indexed in PubMed under the heading “DF” compared to 785 in 2016, with a constantly increasing trend along the years, covering a variety of aspects, from pathogenesis to local and systemic management, from revascularization to Charcot foot surgery.
A substantial number of guidelines and consensus documents have been released and regularly adjourned over the years, and study groups, and even scientific societies, have been created with DF as the subject of interest and focus for research [ 1 – 3 ].
This interest in the DF has been prompted mainly by its increasing prevalence. It has been estimated that 1 out of 3 individuals with diabetes is likely to develop a DF ulcer during his or her lifetime, and going by the characteristics of the pathology, DFU is known to be a progressive condition affecting the lower limb with dramatic consequences, both for the limb and for the individual [ 4 ].
Once every 20s, a limb is being lost globally because of diabetes, and patients with DF have mortality rates that are higher than those of many forms of cancer [ 5 , 6 ].
The DF is a complex disease, with a multifactorial pathogenesis and with multidimensional clinical patterns, ranging from a prevalently ischaemic condition progressively evolving towards a critical end stage to a pure neuropathic disease with an alternance of chronic stable phases and reacutization alongside mixed neuro-ischaemic forms, all leading to ulcerations and eventually getting complicated with infections [ 7 ].
This pathogenetic and clinical complexity, which develops during a long and usually almost asymptomatic pre-clinical course, dramatically turning into a hyperacute phase, evolving frequently into a chronic condition with a high risk of recurrence, should be identified with the more appropriate definition of diabetic foot syndrome (DFS), encompassing all the aspects of the disease [ 8 ].
During the recent 10 years, thanks to some studies that re-shaped the knowledge and clinical evidence on DFS – one for all the EURODIALE study, which has so far produced 15 original papers and 2 reviews – the scientific and clinical profile of this pathology has significantly changed, leading to the understanding that DFS is an organ manifestation of a systemic chronic disease and not just a simple and local ulceration [ 9 , 10 ].
New diagnostic, therapeutic and organizational tools have been put into practice to improve our adequacy to fight the disease; as a consequence, the number of major amputations is decreasing in some countries like the United Kingdom and the United States, and also, life expectancy is increasing [ 11 ].
In this volume of Frontiers in Diabetes , dedicated to the DFS, we collected 16 contributions from some of the most experienced and qualified scientists and clinicians who are experts in the different aspects of the disease, trying to give an up-to-date picture of the clinical scenario, the more recent acquisitions in the understanding of the mechanisms at the base of the pathology, the current standards of therapy and the organizational tasks that a modern approach to such a complex pathology deserves.
We asked all the contributors to submit a paper that should be as much informative and straight-to-the point as possible, including not only their own experience in the field, in any case relevant for the issues for which they have been selected, but also a wider picture that could link each section to the other, so as to produce a volume of Frontiers in Diabetes that would be more than the sum of the sin