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The foot in perspective.

Apelqvist, Jan LU (2008) In Diabetes/Metabolism Research Reviews 24(1). p.110-115
Abstract
The diabetic foot constitutes a tremendous challenge for patients, caregivers and the health care system. The International Consensus Document of 1999 was a milestone in the recognition of the importance and consequences of the diabetic foot. Since then, many original papers have been published in this area.Large cohort studies have given us a deeper understanding regarding factors related to the outcome of diabetic foot ulcers: according to these studies, the severity of diabetic foot ulcers is greater than previously reported. More than 50% of individuals' foot ulcers have signs of infection at admission, and one-third have signs of both peripheral artery disease (PAD) and infection. The co-morbidities increase significantly with... (More)
The diabetic foot constitutes a tremendous challenge for patients, caregivers and the health care system. The International Consensus Document of 1999 was a milestone in the recognition of the importance and consequences of the diabetic foot. Since then, many original papers have been published in this area.Large cohort studies have given us a deeper understanding regarding factors related to the outcome of diabetic foot ulcers: according to these studies, the severity of diabetic foot ulcers is greater than previously reported. More than 50% of individuals' foot ulcers have signs of infection at admission, and one-third have signs of both peripheral artery disease (PAD) and infection. The co-morbidities increase significantly with increasing severity of the foot disease. However, the trend in all these studies is a successive improvement in healing rate (50-60% at 20 weeks follow-up, > 75% at 1 year). It is important to differentiate between neuropathic and neuro-ischaemic ulcers with regard to factors related to outcome and co-morbidities.Recent research has emphasized the importance of psychological factors in the development and outcome of diabetic foot ulcers. Studies have shown that perceptions of the individual's own risks based on symptoms, and their own beliefs in the efficacy of self-care, can affect foot-care practice.The importance and influence of the health care organization and reimbursement should not be underestimated, both in the prevention and management of diabetic foot lesions. The diabetic foot should be considered a lifelong condition, as having had one ulcer dramatically increases the risk of developing a new ulcer.In an individual with diabetes and a foot ulcer, the ulcer should be considered as a sign of multi-organ disease, and a holistic approach to both management and prevention is recommended. Copyright (c) 2008 John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diabetic foot foot ulcers peripheral artery disease neuropathic ulcers neuro-ischaemic ulcers ischaemic foot ulcers
in
Diabetes/Metabolism Research Reviews
volume
24
issue
1
pages
110 - 115
publisher
John Wiley & Sons
external identifiers
  • wos:000256408300023
  • pmid:18384111
  • scopus:44949206713
ISSN
1520-7552
DOI
10.1002/dmrr.834
language
English
LU publication?
yes
id
f4052f18-1bc7-4033-b544-969cad692043 (old id 1147856)
date added to LUP
2008-05-08 08:55:10
date last changed
2017-05-21 04:31:14
@article{f4052f18-1bc7-4033-b544-969cad692043,
  abstract     = {The diabetic foot constitutes a tremendous challenge for patients, caregivers and the health care system. The International Consensus Document of 1999 was a milestone in the recognition of the importance and consequences of the diabetic foot. Since then, many original papers have been published in this area.Large cohort studies have given us a deeper understanding regarding factors related to the outcome of diabetic foot ulcers: according to these studies, the severity of diabetic foot ulcers is greater than previously reported. More than 50% of individuals' foot ulcers have signs of infection at admission, and one-third have signs of both peripheral artery disease (PAD) and infection. The co-morbidities increase significantly with increasing severity of the foot disease. However, the trend in all these studies is a successive improvement in healing rate (50-60% at 20 weeks follow-up, > 75% at 1 year). It is important to differentiate between neuropathic and neuro-ischaemic ulcers with regard to factors related to outcome and co-morbidities.Recent research has emphasized the importance of psychological factors in the development and outcome of diabetic foot ulcers. Studies have shown that perceptions of the individual's own risks based on symptoms, and their own beliefs in the efficacy of self-care, can affect foot-care practice.The importance and influence of the health care organization and reimbursement should not be underestimated, both in the prevention and management of diabetic foot lesions. The diabetic foot should be considered a lifelong condition, as having had one ulcer dramatically increases the risk of developing a new ulcer.In an individual with diabetes and a foot ulcer, the ulcer should be considered as a sign of multi-organ disease, and a holistic approach to both management and prevention is recommended. Copyright (c) 2008 John Wiley & Sons, Ltd.},
  author       = {Apelqvist, Jan},
  issn         = {1520-7552},
  keyword      = {diabetic foot
foot ulcers
peripheral artery disease
neuropathic ulcers
neuro-ischaemic ulcers
ischaemic foot ulcers},
  language     = {eng},
  number       = {1},
  pages        = {110--115},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research Reviews},
  title        = {The foot in perspective.},
  url          = {http://dx.doi.org/10.1002/dmrr.834},
  volume       = {24},
  year         = {2008},
}