Received 24 June 2009; accepted 12 August 2009. published online 23 October 2009.
Background
Diabetic foot problems and their complications are a medical and economic challenge to the health care system and require an aggressive multidisciplinary approach to achieve limb salvage. The goals of this review article are to delve into this comprehensive topic and summarize key points regarding diabetic foot problems from the perspective of the vascular specialist treating these patients.
Methods
The MEDLINE database was searched to identify articles on this topic.
Results
We found 112 relevant articles. These were used to provide current data on (1) the pathogenesis leading to diabetic foot lesions (ie, the etiologic triad of ischemia, neuropathy, and infection), (2) the clinical presentation of these foot lesions and their systemic manifestations, (3) the optimal methods of diagnostic evaluation, including noninvasive testing and arteriography, (4) treatment selection guidelines to help delineate which patients require revascularization, and (5) medical and interventional treatments, including prevention strategies, wound healing strategies, use of antibiotics, and endovascular and open surgical options for revascularization.
Conclusions
The data presented in this review article allow vascular clinicians to optimize patient care and achieve effective limb salvage for this growing segment of the population.
Richard P. Cambria, MD, Section Editor
Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
Reprint requests: Jeffrey Kalish, MD, Fellow in Vascular & Endovascular Surgery, Beth Israel Deaconess Medical Center, 110 Francis St, LMOB 5B, Boston, MA 02215
Competition of interest: none.
The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.
ABSTRACT