Experts: many fubamputations with diabetes avoidable

experts: many fubamputations with diabetes avoidable

Many of the approximately 50.000 fubamputations due to diabetes in germany were avoidable, according to medical experts.

The risk of amputation can be reduced from ten to three percent through regular checks, a close-meshed therapy network and, above all, good cooperation between several experts in the hospital, said ralf lobmann from stuttgart hospital and member of the board of the german diabetes society (DDG).

To the experts he paid diabetologists, surgeons, wound nurses and orthopadie shoe technicians. Among other things, nerves in the fists are damaged by the so-called sugar disease. Because the victims are not in pain, they often recognize injuries too late and an infection or blood poisoning can occur. In the worst case, affected limbs must be removed.

A patient who comes to a regular care hospital has a risk of 10 to 20 percent for an amputation, said lobmann. He referred to so-called major amputations, in which the leg is removed from the fub to about ten centimeters below the knee. In addition, there were many small amputations, in which only one toe is removed. "In a certified facility of the DDG, the amputation rate for major amputation is 3.1 percent. We can see this from more than 30.000 patient traps detected."

Recently, the number of amputations has fallen slightly, said lobmann. "There are still too many."In this context, he also criticized the fact that the reimbursements for conventional – and therefore usually lengthy – treatments had been reduced, while those for amputations had been increased. Unfortunately, there are still too many patients in hospitals where there are no specialists for diabetes.

Often the problems began with "bagatelles," such as a sprained or otherwise injured fub or shoes that were too tight. Due to their illness, many diabetics "no longer actively perceive anything below the knee" – including pain. In addition, the immune system is impaired in diabetes, so wounds heal more poorly. "With diabetics one must look therefore regularly at the tube and take also a trifle trauma seriously."The DDG also advocates a second opinion before an amputation. "Most amputations can be planned. It does not matter whether they take place after 24 or 48 hours."

According to lobmann, there are about eight million patients in germany who have been diagnosed with diabetes type II. About 300.000 people had type I, which also affects children.

In nurnberg, surgeon and chief physician martinus richter from rummelsberg hospital also presented a therapy and surgical method that can be used to correct deformed fubs. The deformations often lead to dangerous wounds. During the operation, long screws are inserted into the fub to stabilize it. In a study with 300 patients, the risk of a recurrence of the fubes was reduced by the intervention from 70 to 15 percent.

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