Interpretation and application of Guidelines on Interventions to Enhance Healing of Foot Ulcers in diabetic patients(IWGDF2023 Update)
柳岚 1车建芳 1崔悦 1孙金姗 1王爱萍1
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作者信息
1. 东部战区空军医院糖尿病足中心,南京 210002
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摘要
促愈合干预措施是糖尿病足溃疡(diabetic foot ulcers,DFUs)治疗中不可或缺的一环.2023 年新近发布的国际糖尿病足工作组(International Working Group on the Diabetic Foot,IWGDF)指南相关章节与2019年的相比,最主要的变化是补充了各条推荐的证据内容,且所纳入的研究均为随机对照试验(randomized controlled trials,RCTs).本文从清创、敷料、氧气和其他气体、物理治疗、生物制剂(皮肤替代物,自体或其他细胞产品)、药物、负压治疗以及教育和生活支持这8个方面进行两份指南的对比;同时,结合临床实践,探讨2023年版指南在临床可能的实际应用与不足.
Abstract
Healing-promoting interventions are an indispensable part of the treatment for diabetic foot ulcers(DFUs).The newly released 2023 guidelines by the International Working Group on the Diabetic Foot(IWGDF)had significant updates compared to the 2019 version,particularly by including evidence for each recommendation derived from randomized controlled trials(RCTs).This article compared the two sets of guidelines across eight aspects:debridement,dressings,oxygen and other gases,physical therapy,bio-logical agents(skin substitutes,autologous or other cell products),drugs,negative pressure therapy,and education and lifestyle support.Additionally,we discussed the potential practical applications and limitations of the 2023 guidelines in clinical practice.