The Diabetes Center, part of the Herz- und Diabeteszentrum NRW (HDZ NRW), has once again achieved re-certification as an "Outpatient and Inpatient Foot Treatment Center", an award which its Director, Professor Dr. Dr. h.c. Diethelm Tschöpe, was happy to receive.
Since 2003, the German Diabetes Society (DDG) has been certifying institutions able to guarantee patient treatment in strict accordance with its guidelines. The declared aim of the specialist society is to improve the quality of patient care in Germany both continually and nationwide. Treatment of the secondary disease "diabetic foot syndrome" is complex and lengthy - often requiring a stay in hospital.
"One in four persons with diabetes must expect to suffer from diabetic foot syndrome in the course of this lifelong disease", Professor Tschöpe said. Increasingly, it is elderly patients who are affected. "The cause can be a diabetes-related malfunctioning of the peripheral nerves, so-called polyneuropathy. But vascular diseases causing impaired perfusion can also be responsible for poor healing of foot wounds."
Top priority: preservation of extremities
In order to avert the threat of toe, calf or thigh amputation, it is important to acknowledge the seriousness of the situation as soon as possible. "It is definitely our recommendation that diabetics who have any acute foot-related problems be treated immediately and as an emergency", said Senior Physician Dr. medic. Tania-Cristina Costea, Manager of the Wound Healing Center within the Diabetes Center. But promoting the healing of chronic wounds and preserving extremities alone is not enough. "Diagnostics should specifically include the vessels and any possible polyneuropathy, and in particular should check the blood sugar adjustment." In order to treat diabetic foot syndrome successfully, physicians, podologists, wound assistants, orthopedic shoemakers and technicians, nurses, and diabetes consultants must all work together in a combined interdisciplinary effort.
The DDG has once again recognized how excellently this collaboration functions between the various specialists at the HDZ NRW. To gain certification, it is necessary to prove that the principles of diabetic foot syndrome treatment are adhered to at all times, that all diagnostic and treatment routines take place in a coordinated manner, and that preventive measures are also considered. A two-way exchange of experience with other certified centers is a further stipulation.
East Westphalia-Lippe currently has 8 outpatient (in Germany 209) and 3 inpatient (in Germany 87) foot treatment centers certified according to the DDG criteria. Focal points of the Wound Healing Center within the Diabetes Center at the HDZ NRW are in-depth diagnostics, as well as infection therapy and systematic antibiotic therapy. Treatments which aim to promote wound healing include autohemotherapy and maggot therapy, while innovative procedures such as cold plasma or fish skin therapy are also being tested. One special focus is the treatment of Charcot foot, a condition involving deformed foot joints arising from sprains or fractures which go unnoticed due to a lack of pain sensitivity. The top priority here is to reduce the pressure on affected regions and rest them.
"Diabetic foot syndrome is currently one of the chief causes of amputations", Professor Tschöpe stressed. "Many of them could be prevented with early diagnosis and treatment." One of the DDG certification requirements is therefore a guaranteed second opinion before any amputation takes place.
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