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Das diabetische Fußsyndrom aus angiologisch-diabetologischer Sicht

Diabetic foot syndrome from the perspective of angiology and diabetology

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Zusammenfassung

Das diabetische Fußsyndrom (DFS) ist eine der bedeutsamsten Komplikationen des Diabetes mellitus und führt bei unsachgemäßer Diagnostik und Therapie häufig zu hohen Amputationsraten der betroffenen Extremität. Die kardiovaskuläre Mortalität und Morbidität der betroffenen Patienten ist unverändert hoch. Die Pathogenese ist komplex und beinhaltet häufig neuropathische und infektiöse Veränderungen. Eine periphere arterielle Durchblutungsstörung verschlechtert die Prognose entscheidend. Zur Reduktion der Amputationsrate ist die frühzeitige und spezialisierte Behandlung von peripheren Durchblutungsstörungen von herausragender Bedeutung. Die Therapie beinhaltet Druckentlastung, Wundsäuberung, stadiengerechte lokale Wundbehandlung, die sachgerechte Bekämpfung von bakteriellen Infektionen und die Verbesserung der Durchblutung. Präventiv sind neben der Stoffwechseleinstellung die Schulung von Diabetikern und deren Angehörigen und die angepasste Schuhversorgung hilfreich.

Abstract

The diabetic foot syndrome (DFS) is one of the most significant complications of diabetes mellitus and frequently leads to amputation of the affected extremity. Cardiovascular mortality and morbidity of affected patients are still high and healed ulcers often recur. The pathogenesis of DFS is complex, clinical presentation is variable and management requires early expert assessment. Interventions should be directed towards infection, peripheral ischemia and pressure relief caused by peripheral neuropathy and limited joint mobility. Treatment includes wound clean-up, stage-oriented local wound management and the appropriate treatment of bacterial infection. Useful preventive measures are blood glucose control training of diabetics, regular foot care and the provision of appropriate footwear.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Referentenhonorare für Verträge: Bayer Vital GmbH, UCB Schwarz Pharma Deutschland, Sanofi-Aventis

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  1. Angiologie/Diabetologie, SRH-Klinikum Karlsbad-Langensteinbach, Akademisches Lehrkrankenhaus der Universität Heidelberg, Guttmannstraße 1, 76307, Karlsbad, Deutschland

    H. Lawall & C. Diehm

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  1. H. Lawall
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  2. C. Diehm
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Correspondence to H. Lawall.

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Lawall, H., Diehm, C. Das diabetische Fußsyndrom aus angiologisch-diabetologischer Sicht. Orthopäde 38, 1149–1159 (2009). https://doi.org/10.1007/s00132-009-1501-z

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