Diabetisches Fußsyndrom

Definition

Unter diabetischem Fußsyndrom versteht man alle pathologischen Veränderungen am Fuß eines Menschen mit Diabetes mellitus und diabetischer Polyneuropathie. Ulzera oder Nekrosen entwickeln sich meist als Folge von repetitivem Stress bei eingeschränkter Schmerzempfindung (hohe Druckbelastung und Scherkräfte, insbesondere bei Fuß- und Zehendeformitäten). In Deutschland liegt zudem bei mehr als 50 % der Fälle eine relevante PAVK vor.

• Literatur

• 1 Claessen H, Narres M, Haastert H. et al. Lower-extremity amputations in people with and without diabetes in Germany, 2008–2012 – an analysis of more than 30 million inhabitants. Clin Epidemiol 2018; 10: 475-488
• 2 Fedorko L, Bowen JM, Jones W. et al. Hyperbaric Oxygen Therapy Does Not Reduce Indications for Amputation in Patients With Diabetes With Nonhealing Ulcers of the Lower Limb: A Prospective, Double-Blind, Randomized Controlled Clinical Trial. Diabetes Care 2016; 39 (03) 392-399
• 3 Santema KTB, Stoekenbroek RM, Koelemay MJW. et al. Hyperbaric Oxygen Therapy in the Treatment of Ischemic Lower-Extremity Ulcers in Patients With Diabetes: Results of the DAMO2CLES Multicenter Randomized Clinical Trial. Diabetes Care 2018; 41 (01) 112-119
• 4 Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab Res Rev 2004; 20 (Suppl. 01) S90-S95 . Review
• 5 Lipsky BA, Berendt AR, Deery HG. et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004; 39 (07) 885-910
• 6 Edmonds M, Lázaro-Martínez JL, Alfayate-García JM. et al. Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, doubleblind, randomised, controlled trial. Lancet Diabetes Endocrinol 2018; 6 (03) 186-196
• 7 Game F, Jeffcoate W, Tarnow L. et al. LeucoPatch system for the management of hard-to-heal diabetic foot ulcers in the UK, Denmark, and Sweden: an observer-masked, randomised controlled trial. Lancet Diabetes Endocrinol 2018; 11: 870-878
• 8 Lavery LA, Fulmer J, Shebetka KA. et al. The efficacy and safety of Grafix(®) for the treatment of chronic diabetic foot ulcers: results of a multi-centre, controlled, randomised, blinded, clinical trial. Int Wound J 2014; 5: 554-560
• 9 THE 2019 IWGDF GUIDELINES. https://iwgdfguidelines.org/guidelines/guidelines/