Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide
BackgroundDiabetic foot disease is a serious complication of diabetes mellitus. Patients with diabetes mellitus have a 25% lifetime risk for developing a foot ulcer, and between 14% and 24% of patients require a major or minor lower limb amputation due to severe gangrene. However, decisions concerni...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003339/full |
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| author | Xuan Liao Sheng-Hong Li Mariya Mohamad El Akkawi Xiao-bing Fu Hong-wei Liu Yue-sheng Huang |
| author_facet | Xuan Liao Sheng-Hong Li Mariya Mohamad El Akkawi Xiao-bing Fu Hong-wei Liu Yue-sheng Huang |
| author_sort | Xuan Liao |
| collection | DOAJ |
| description | BackgroundDiabetic foot disease is a serious complication of diabetes mellitus. Patients with diabetes mellitus have a 25% lifetime risk for developing a foot ulcer, and between 14% and 24% of patients require a major or minor lower limb amputation due to severe gangrene. However, decisions concerning whether to amputate or whether to perform a major or minor lower limb amputation, and how best to determine the amputation plane remain unclear.MethodsTo consolidate the current literature with expert opinion to make recommendations that will guide surgical amputation for patients with diabetic foot ulcers. A total of 23 experts experienced in surgical treatment of patients with diabetic foot ulcers formed an expert consensus panel, and presented the relevant evidence, discussed clinical experiences, and derived consensus statements on surgical amputation for patients with diabetic foot ulcers. Each statement was discussed and revised until a unanimous consensus was achieved.ResultsA total of 16 recommendations for surgical amputation for patients with diabetic foot ulcers were formulated. The experts believe that determination of the amputation plane should be comprehensively evaluated according to a patient's general health status, the degree of injury, and the severity of lower limb vasculopathy. The Wagner grading system and the severity of diabetic lower extremity artery disease are important criteria when determining the degree of amputation. The severity of both diabetic foot infection and systemic underlying diseases are important factors when considering appropriate treatment. Moreover, consideration should also be given to a patient's socioeconomic status. Given the complexities of treating the diabetic foot, relevant issues in which consensus could not be reached will be discussed and revised in future.ConclusionThis expert consensus could be used to guide doctors in clinical practice, and help patients with diabetic foot ulcers gain access to appropriate amputation treatment. |
| first_indexed | 2024-04-11T17:48:36Z |
| format | Article |
| id | doaj.art-40cfae8d107b478f82675742b2d6b64b |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T17:48:36Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-40cfae8d107b478f82675742b2d6b64b2022-12-22T04:11:12ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-11-01910.3389/fsurg.2022.10033391003339Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guideXuan Liao0Sheng-Hong Li1Mariya Mohamad El Akkawi2Xiao-bing Fu3Hong-wei Liu4Yue-sheng Huang5Department of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, ChinaDepartment of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, ChinaDepartment of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, ChinaWound Healing and Cell Biology Laboratory, Institute for Basic Research, Trauma Center of Postgraduate Medical College, General Hospital of PLA, Beijing, ChinaDepartment of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, ChinaDepartment of Wound Repair; Institute of Wound Repair and Regeneration Medicine, Southern University of Science and Technology Hospital, Southern University of Science and Technology School of Medicine, Shenzhen, ChinaBackgroundDiabetic foot disease is a serious complication of diabetes mellitus. Patients with diabetes mellitus have a 25% lifetime risk for developing a foot ulcer, and between 14% and 24% of patients require a major or minor lower limb amputation due to severe gangrene. However, decisions concerning whether to amputate or whether to perform a major or minor lower limb amputation, and how best to determine the amputation plane remain unclear.MethodsTo consolidate the current literature with expert opinion to make recommendations that will guide surgical amputation for patients with diabetic foot ulcers. A total of 23 experts experienced in surgical treatment of patients with diabetic foot ulcers formed an expert consensus panel, and presented the relevant evidence, discussed clinical experiences, and derived consensus statements on surgical amputation for patients with diabetic foot ulcers. Each statement was discussed and revised until a unanimous consensus was achieved.ResultsA total of 16 recommendations for surgical amputation for patients with diabetic foot ulcers were formulated. The experts believe that determination of the amputation plane should be comprehensively evaluated according to a patient's general health status, the degree of injury, and the severity of lower limb vasculopathy. The Wagner grading system and the severity of diabetic lower extremity artery disease are important criteria when determining the degree of amputation. The severity of both diabetic foot infection and systemic underlying diseases are important factors when considering appropriate treatment. Moreover, consideration should also be given to a patient's socioeconomic status. Given the complexities of treating the diabetic foot, relevant issues in which consensus could not be reached will be discussed and revised in future.ConclusionThis expert consensus could be used to guide doctors in clinical practice, and help patients with diabetic foot ulcers gain access to appropriate amputation treatment.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003339/fulldiabetic foot managementdiabetic foot ulceramputationwound healingexpert consensus |
| spellingShingle | Xuan Liao Sheng-Hong Li Mariya Mohamad El Akkawi Xiao-bing Fu Hong-wei Liu Yue-sheng Huang Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide Frontiers in Surgery diabetic foot management diabetic foot ulcer amputation wound healing expert consensus |
| title | Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide |
| title_full | Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide |
| title_fullStr | Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide |
| title_full_unstemmed | Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide |
| title_short | Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide |
| title_sort | surgical amputation for patients with diabetic foot ulcers a chinese expert panel consensus treatment guide |
| topic | diabetic foot management diabetic foot ulcer amputation wound healing expert consensus |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1003339/full |
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