Diabetic foot therapy saves amputation

Diabetes: New therapy saves amputation in diabetic foot
Scientists at the University Hospital Carl Gustav Carusan of the Dresden University of Technology have published a scientific study in the run-up to the World Diabetes Day (November 14), proving that specialized treatment of patients with diabetic foot can and leg amputations. Thus also the chance of survival and quality of life of the patients increase, so the statements of the Dresden physicians.

High blood sugar levels damage vessels and lead to a circulatory disorder
Too high a blood sugar level damages the vessels on the one hand and causes arterial circulatory disturbances, which makes wounds very difficult or even impossible to cure and, on the other hand, causes a deficiency supply which leads to damage to the peripheral nerves, so that small and larger injuries to the legs sometimes go unnoticed. Since these subsequently heal only difficult, it comes in connection with the arterial circulatory disorders - especially in the feet - more often to the death of tissue, after which the doctors react to today in many cases with an amputation of the foot or partially the whole leg. The death rate among patients in such an acute stage of the disease is relatively high. Senior Physician Hannes Rietzsch from the Department of Medicine III at the University Hospital Carl Gustav Carus emphasized: „The mortality of patients after leg amputations is up to 30 percent in the first year. Because of the severe underlying disease of diabetes and its consequences, they often do not cope with the major surgery.“

Better forms of treatment developed for diabetic foot
In the on the treatment of the „Diabetic foot“ (Diabetic Foot Syndrome DFS) Department of the University Hospital Dresden, the experts have overseen 172 patients with foot ulcers (foot problems due to circulatory disorders) over a year with a structured interdisciplinary treatment by a specialized team of doctors, nurses, physiotherapists, podiatrists and shoemakers. Seventy-five percent of the patients survived without a large-scale amputation, as their limbs could be rescued by intensive treatment of pressure sores and wounds, as well as minor amputations. 20 percent of the study participants had died and the remaining 5 percent lived with only one or no leg, emphasized the responsible professor Sebastian M. Schellong. Treatment successes were ten times better when patients were included in the "Diabetic Foot Outpatient Clinic" after hospitalization, according to the expert in presenting the study results.

Chronic foot wounds are one of the most serious complications of diabetes
„Chronic foot wounds are one of the most serious complications of diabetes“ and the so-called diabetic foot occurs in about 15 percent of diabetics, said the senior physician Hannes Rietzsch the background of the current study. Here, circulatory disorders lead to the death of tissue, which makes amputation of the foot or even of the leg necessary if treatment is too late or not optimal, according to Rietzsch. Your study showed, „that the large outlay in hospital and ambulance translates directly into a measurable treatment benefit for patient survival and the prevention of leg amputations“, added Prof. Schellong.

The prerequisite for this, however, are specialized teams of doctors, nurses, physiotherapists, podiatrists and shoemakers, who are not yet included in the budget of the statutory health insurance benefits. „It needs a salary that allows doctors, nurses and podiatrists to pay“, emphasized Prof. Schellong. So far, the clinic in the flat-rate compensation system with their treatment offer losses, but the special treatment of affected diabetics could reduce the proportion of amputations above the ankle from 50 to 10 percent, according to the experts. (fp, 08.11.2010)

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