The intersocietal IWGDF, ESVS, SVS guidelines on peripheral artery disease in people with diabetes mellitus and a foot ulcer.

Autor:	Fitridge R; Faculty of Health and Medical Sciences, University of Adelaide and Vascular and Endovascular Service, Royal Adelaide Hospital Adelaide, Australia. Electronic address: robert.fitridge@adelaide.edu.au., Chuter V; School of Health Sciences, Western Sydney University, Campbelltown, Australia., Mills J; Baylor College of Medicine, Houston, TX, USA., Hinchliffe R; Bristol Centre for Surgical Research, University of Bristol, Bristol, UK., Azuma N; Asahikawa Medical University, Hokkaido, Japan., Behrendt CA; Department of Vascular and Endovascular Surgery, Asklepios Clinic Wandsbek, Asklepios Medical School, Hamburg, Germany., Boyko EJ; University of Washington, Seattle, WA, USA., Conte MS; University of California, San Francisco Medical Centre, CA, USA., Humphries M; UC Davis Medical Centre, Sacramento, CA, USA., Kirksey L; The Cleveland Clinic, Cleveland, OH, USA., McGinigle KC; University of North-Carolina, Chapel Hill, NC, USA., Nikol S; Clinical and Interventional Angiology, Asklepios Klinik, St Georg, Hamburg, Germany., Nordanstig J; Sahlgrenska University Hospital, Gothenburg, Sweden., Rowe V; David Geffen School of Medicine, UCLA, Los Angeles, CA, USA., Russell D; Leeds Teaching Hospitals NHS Trust, Leeds, UK., van den Berg JC; CENTRO VASCOLARE TICINO Ospedale Regionale di Lugano, sede Civico and Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie Inselspital, Universitätsspital Bern Switzerland., Venermo M; Helsinki University Hospital, University of Helsinki, Helsinki, Finland., Schaper N; Division of Endocrinology, Dept. Internal Medicine, MUMC+, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of vascular surgery [J Vasc Surg] 2023 Nov; Vol. 78 (5), pp. 1101-1131. Date of Electronic Publication: 2023 Sep 20.
DOI:	10.1016/j.jvs.2023.07.020
Abstrakt:	Diabetes related foot complications have become a major cause of morbidity and are implicated in most major and minor amputations globally. Approximately 50% of people with diabetes and a foot ulcer have peripheral artery disease (PAD) and the presence of PAD significantly increases the risk of adverse limb and cardiovascular events. The International Working Group on the Diabetic Foot (IWGDF) has published evidence based guidelines on the management and prevention of diabetes related foot complications since 1999. This guideline is an update of the 2019 IWGDF guideline on the diagnosis, prognosis, and management of peripheral artery disease in people with diabetes mellitus and a foot ulcer. For this updated guideline, the IWGDF, the European Society for Vascular Surgery, and the Society for Vascular Surgery decided to collaborate to develop a consistent suite of recommendations relevant to clinicians in all countries. This guideline is based on three new systematic reviews. Using the Grading of Recommendations, Assessment, Development and Evaluation framework clinically relevant questions were formulated, and the literature was systematically reviewed. After assessing the certainty of the evidence, recommendations were formulated which were weighed against the balance of benefits and harms, patient values, feasibility, acceptability, equity, resources required, and when available, costs. Through this process five recommendations were developed for diagnosing PAD in a person with diabetes, with and without a foot ulcer or gangrene. Five recommendations were developed for prognosis relating to estimating likelihood of healing and amputation outcomes in a person with diabetes and a foot ulcer or gangrene. Fifteen recommendations were developed related to PAD treatment encompassing prioritisation of people for revascularisation, the choice of a procedure and post-surgical care. In addition, the Writing Committee has highlighted key research questions where current evidence is lacking. The Writing Committee believes that following these recommendations will help healthcare professionals to provide better care and will reduce the burden of diabetes related foot complications. (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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