• The Monthly Diabetes
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• s.289
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• pp.19-25
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• 2013

당뇨병은 비외상성 하지 절단의 가장 중요한 원인 질환이다. 당뇨병성 족부병변은 당뇨병 환자의 발에 발생하는 모든 문제를 포괄적으로 의미하고 보행 장애나 하지절단을 가져오는 중한 합병증에 속하며 족부병변의 발생률은 당뇨병성 만성합병증에 대한 지속적인 교육과 관리를 통해 점차 감소추세이지만 5.3~10.5% 정도로 아직도 적지 않게 보고되고 있다.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.19-20
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• 2008

• The Monthly Diabetes
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• s.210
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• pp.17-18
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• 2007

당뇨병성 족부병변은 당뇨병성 신경증, 허혈증, 그리고 골관절병 등에 의해서 감염, 궤양 등 하지의 조직이 파괴된 상태로 당뇨병환자의 하지절단, 사망률 등을 높이는 중요한 원인이다. 전세계적으로 하지절단의 가장 많은 원인이 당뇨병성 족부병변이며, 당뇨병환자는 정상인에 비해 하지절단의 위험이 약 15배 가량 높다. 또한 5$\sim$15% 정도의 당뇨병환자가 일생 동안 하지절단에 직면하게 된다고 하고, 한쪽 다리를 절단하면 다른 한쪽도 절단할 확률이 1$\sim$3년 이내에 40%, 3$\sim$5년 사이에 58% 정도이며, 일단 하지절단 후에는 3년 생존률이 50%에 이른다는 보고도 있다.

• The Korean Chronic Disease News
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• no.295
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• pp.16.3-16.3
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• 2005

• 대한미세수술학회:학술대회논문집
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• 1999.11a
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• pp.214-215
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• 1999

• The Monthly Diabetes
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• s.258
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• pp.42-43
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• 2011

`모르는 게 약이다'라는 말이 있다. 그러나 이 말은 옛말에 불과하다. 당뇨병은 아는 만큼 효과적으로 관리할 수 있고 관리한 만큼 건강을 유지할 수 있는 병이다. 교육을 통해 올바른 치료와 혈당 관리를 한다면 평생 건강을 유지할 수 있고, 관심을 기울이지 않고 내버려둔다면 합병증이 생겨 실명하거나 발을 잘라내게 되는 무서운 질병이다. 그러나 관리를 하자니 규칙적인 운동, 정해진 양의 식사, 인슐린과 약물 복용 등 신경쓸게 한둘이 아니다. 그러므로 병원에서 실시하고 있는 교육 프로그램을 받아 올바른 당뇨관리를 실천해야 한다. 이에 삼성서울병원 당뇨병센터에서 준비한 '당뇨병성 족부 병변'과 '올바른 인슐린 주사법' 특강을 듣고 인슐린 주사법과 효과적인 발 관리를 통한 합병증 예방의 비결을 알아보았다.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.684-689
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• 2004

One of the serious long-tenn complications of diabetes mellitus is the diabetic foot lesion. Diabetic foot lesions are a major cause of morbidity, mortality, disability in patients with diabetes and frequent cause of lower-extremity amputations. The treatment of diabetic foot lesions is based on the strict control of diabetes mellitus. A patient with diabetic foot lesions was treated with Cheunhwasangamibang and improvement was seen. Results in this case support a role for Cheunhwasangamibang in controlling diabetes mellitus, and are here reported to encourage further study.

• Physical Therapy Korea
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• v.5 no.2
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• pp.98-105
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• 1998

The purposes of this article are to review the pathogenesis, prevention, and management of amputation due to diabetes mel1itus complications, and to report one case who had lost his toes due to diabetes mellitus. A primary cause for hospital admission of the patient was foot ulcer. Since many amputations in diabetic patients are precipitated by such ulcers, a program for active prevention and optimal treatment of diabetic foot lesions might decrease the risk of amputation. Diabetic foot ulcers and, ultimately, amputation can stem from a variety of pathways. The combination of peripheral neuropathy, peripheral vascular disease and infections is the harbinger of the final cataclysmic events of gangrene and amputation. As the physical therapist is often involved in the treatment of diabetic patients, the therapist should be aware of the followings: the patient's type of diabetes and the severity of the diabetes, the complications of the disease, the effects of exercise, the importance of wearing proper shoes and education to patients about appropriate diabetic foot care.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.35-39
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• 2002

Purpose: The purpose of this study was to evaluate the effect of hyperbaric oxygen therapy(HBOT) and the resultant amputation rate in the treatment of diabetic foot ulcer. Material and methods: From 2000 Jan. to 2002 April, thirty two diabetic foot patients were admitted for treatment of foot ulcers and infection. Of the thirty two cases, thirteen patients received HBOT and nineteen did not. The results were analyzed by amputation rate and healing time. All were classified according to the Wagner classification. Results: Of the HBOT treated group, three(23%) patients underwent amputation: two below knee and one metatarsophalangeal disarticulations. Of the non-treated group, eleven(58%) patients underwent amputation, : four below knee and seven metatarsophalangeal disarticulations. The healing times, based on hospital days were average 16, 38, 43 days in the HBOT treated group and average 20, 50, 35 days in the non treated group respectively in Wagner grade II, III, IV. Conclusions: HBOT might be effective in decreasing amputation rate and hospital stay in diabetic patients with severe foot ulcers.

• Journal of Korean Foot and Ankle Society
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• v.25 no.2
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• pp.100-107
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• 2021

Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to gram-positive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion: This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.