Surgical Perspective in Treatment of Diabetic Foot Ulcers
Surgical Perspective in Treatment of Diabetic Foot Ulcers
Despite attempts at prophylaxis, foot ulcers remain a frequent complication of diabetes. Delayed or inadequate treatment of foot infections in diabetic patients often results in limb loss. A team approach with involved specialties provides the best option for good long-term patient outcomes. Continued education is necessary in order to limit avoidable major amputation in this challenging patient population.
In 1997, the Centers for Disease Control and Prevention estimated that in the United States 15.7 million people had diabetes mellitus, both diagnosed and undiagnosed. Diabetes is the sixth leading cause of death in the United States. Total costs of this disease have been estimated to be in excess of 98 billion dollars annually. The costs can be divided into direct costs that are a result of medical complications of the disease, and indirect costs that accrue from loss of productivity, rehabilitation, pain, and suffering. Diabetic complications may involve the circulatory, ophthalmic, renal, nervous, and cutaneous organ systems.
Diabetic foot problems are an important subset of these complications. Recent estimates show that approximately 15 percent of diabetic patients develop foot ulcers in their lifetime. Patients afflicted most commonly by this problem are 45 to 65 years of age. In a recent prospective study, the average cost of treating one diabetic ulcer was reported to be $6,664. The annual healthcare costs, both direct and indirect, related to diabetic foot ulcers alone are more than $20 billion.
Management of these often-complicated lesions can be both challenging and rewarding. Multiple specialists are often involved in the care of these patients, which results in many consults and redundant testing. A careful, coordinated effort between the primary care physician, vascular surgeon, orthopedist, and podiatrist is essential for good outcomes. A focused diagnostic evaluation with treatment of the etiologic factors associated with development of the problem is necessary for good, long-term results. After the ulcer has been treated, a prophylactic regimen of self-examination and podiatric care, as well as improved control of blood sugar levels, limit recurrence.
Despite attempts at prophylaxis, foot ulcers remain a frequent complication of diabetes. Delayed or inadequate treatment of foot infections in diabetic patients often results in limb loss. A team approach with involved specialties provides the best option for good long-term patient outcomes. Continued education is necessary in order to limit avoidable major amputation in this challenging patient population.
In 1997, the Centers for Disease Control and Prevention estimated that in the United States 15.7 million people had diabetes mellitus, both diagnosed and undiagnosed. Diabetes is the sixth leading cause of death in the United States. Total costs of this disease have been estimated to be in excess of 98 billion dollars annually. The costs can be divided into direct costs that are a result of medical complications of the disease, and indirect costs that accrue from loss of productivity, rehabilitation, pain, and suffering. Diabetic complications may involve the circulatory, ophthalmic, renal, nervous, and cutaneous organ systems.
Diabetic foot problems are an important subset of these complications. Recent estimates show that approximately 15 percent of diabetic patients develop foot ulcers in their lifetime. Patients afflicted most commonly by this problem are 45 to 65 years of age. In a recent prospective study, the average cost of treating one diabetic ulcer was reported to be $6,664. The annual healthcare costs, both direct and indirect, related to diabetic foot ulcers alone are more than $20 billion.
Management of these often-complicated lesions can be both challenging and rewarding. Multiple specialists are often involved in the care of these patients, which results in many consults and redundant testing. A careful, coordinated effort between the primary care physician, vascular surgeon, orthopedist, and podiatrist is essential for good outcomes. A focused diagnostic evaluation with treatment of the etiologic factors associated with development of the problem is necessary for good, long-term results. After the ulcer has been treated, a prophylactic regimen of self-examination and podiatric care, as well as improved control of blood sugar levels, limit recurrence.
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