Diabetic foot historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Daniel A. Gerber, M.D. [2] Anahita Deylamsalehi, M.D.[3]
Overview
The discovery of the association between diabetes and foot ulceration and subsequent infection dates back to the 1850s. Significant breakthroughs in the management of diabetic foot wounds include the introduction of surgical debridement occurred in the early 1900s by Frederick Treves. He also introduced the critical role of footwear in diabetic foot ulcers. Furthermore the discovery of penicillin in 1928 by Alexander Fleming reduced the mortality rate of diabetic foot patients and their related complications significantly. Throughout the 20th century, advances in surgical limb revascularization and the advent of angioplasty drastically reduced the need for amputation. The latter method remained the mainstays of diabetic foot management, in the 2004 and 2012 Infectious Disease Society of America guidelines.
Historical Perspective
Discovery
- Marchal de Calvi and Thomas Hodgkin first identified an association between diabetes and foot ulceration and potential infection of that, as a significant source of morbidity and mortality among these patients, in 1850s. All skin ulcers at that time were treated with prolonged bedrest, however these lesions didn't response to immobilization.[1][2]
- At the turn of the 19th century, Frederick Treves introduced surgical debridement of diabetic wounds as well as modified footwear in order to distribute pressure more evenly across the heal.[2]
- A significant breakthrough occurred in 1928, when a Scottish scientist, Alexander Fleming discovered penicillin, which further reduced mortality and morbidity (such as major amputation) from diabetic foot infections by nearly 50%.[1][2]
- Throughout the 20th century, advances in surgical limb revascularization and the advent of angioplasty drastically reduced the need for amputation and remained a mainstay of treatment.[3][4]
- In 2004, the Infectious Disease Society of America published initial clinical practice guideline for the diagnosis and treatment of diabetic foot infection and with recent updates in 2012, provide an up-to-date diagnostic and therapeutic information to clinicians.[5]
References
- ↑ 1.0 1.1 McKittrick LS (1946). "Recent advances in the care of the surgical complications of diabetes mellitus". N Engl J Med. 235 (26): 929–32. Text "pmid 20277657" ignored (help)
- ↑ 2.0 2.1 2.2 McKittrick LS, McKittrick JB, Risley TS (1949). "Transmetatarsal amputation for the infection or gangrene in patients with diabetes mellitus". Ann Surg. 130 (4): 826–40. Text "pmid 17859470" ignored (help)
- ↑ Sanders LJ, Robbins JM, Edmonds ME (2010). "History of the team approach to amputation prevention: pioneers and milestones". J Vasc Surg. 52 (3): 3–16. Text "pmid 20804927 " ignored (help)
- ↑ LoGerfo FW, Gibbons GW, Pomposelli FB Jr, Campbell DR, Miller A, Freeman DV, Quist WC (1992). "Trends in the care of the diabetic foot. Expanded role of arterial reconstruction". Arch Surg. 127 (5): 617–620. Text "pmid 1575632" ignored (help)
- ↑ Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG, Embil JM, Joseph WS, Karchmer AW, Pinzur MS, Senneville E, Infectious Diseases Society of America (2012). "2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections". Clin Infect Dis. 54 (12): e132. Text "pmid 16822461" ignored (help)