The course entitled “Critical limb ischemia and diabetic foot” will be held on October 25th at the Hotel Terre di Eolo in Patti. The purpose of this meeting, the result of a long and consolidated collaboration between the Hemodynamics and Vascular Surgery departments of the Barone Romeo Hospital in Patti, directed respectively by Dr. Salvatore Garibaldi and Dr. Salvatore Barbera, is to address the topic in a multidisciplinary way and to create a territorial network that involves multiple professional figures for a more complete and timely management of the disease. Chronic critical ischemia of the lower limbs when associated with diabetes mellitus and compromised integrity of the foot falls within the definition of “diabetic foot”.
It manifests itself with pain, ulcerations or gangrene that make walking impossible, often segregating the patient at home. In addition to profoundly undermining the dignity of those who suffer from it, it often has a disastrous outcome, leading to major amputations and death if not treated adequately in the shortest possible time. Suffice it to say that it has a mortality and survival rate comparable to some oncological diseases. In practice, critical limb ischemia has all the requirements to be considered a time-dependent pathology.
The large number of amputations recorded per year not only in Sicily but also in the rest of the world, where it is estimated that every 20 seconds a limb is amputated due to diabetes, must be subjected to careful critical reflection, among the causes: the lack of attention to the prevention of risk factors; lack of sanitation; the delayed or absent treatment of skin lesions and arterial revascularization, essential for the healing of ulcers. To significantly reduce the number of amputations it is therefore necessary to improve the ability to intercept the patient before he develops infection of the skin ulcers, the ultimate cause of amputations, through a territorial network made up of a multidisciplinary team which will have the task of following the patient even after the initial treatment. Percutaneous revascularization (angioplasty) of the arteries of the leg and foot, aimed at limb salvage, carried out in haemodynamic laboratories, represents an added value that can be used even when traditional surgical techniques are no longer feasible. As already mentioned, thanks to timely arterial revascularization (endovascular or surgical), which allows an adequate blood supply necessary for the healing of skin ulcers, amputation of the lower limbs in an appreciable number of cases could be avoided, delayed or limited in its extension, with an important impact both in terms of prognosis and quality of life for the patient and economically for the Regional Health System.
In facing such a ferocious disease, none of us can have definitive solutions: only through everyone’s collaboration can strategies and programs emerge to be pursued together. As proof of the high scientific value of the course, attended by the General Director of Asp Messina, Dr. Joseph. Cuccì, is the participation, as a member of the scientific committee and as speaker, of Dr. Roberto Ferraresi, international point of reference in the field of diabetic foot revascularization.
