The role of microcirculatory techniques in patients with diabetic foot syndrome

Background: Diabetic Soot syndrome (DFS) is a frequent complication of long -standing diabetes mellitus, occurring in 10 to 30 percent of all diabetics with a vital risk for the affected limb and high mortality rates. Macroang iopathy, diabetic polyneuropathy and infections are trigger factors for DFS . Recent results imply a pathogenic role of functional and structural micro circulatory changes. The exact role of microangiopathy and the value of mic rocirculatory diagnostic methods in DFS have not yet been defined. Patients and methods: 78 patients with DFS (28 type I, 50 type II diabetics , mean age 63 years) were evaluated with video capillary microscopy, transc utaneous partial oxygen tension (tcpO(2)) measurement and laser Doppler flu xmetry (LDF) at the forefoot of the affected leg at admission and after rev ascularisation. Mean hospital stay was 28 +/- 11.7 days. Patients were stra tified according to the etiology, of DFS in patients with neuropathic lesio ns, macroangiopathic ulcers and mixed neuropathic-angiopathic lesions. Results: All groups had impaired microcirculation, and significant differen ces between groups were found in respect to capillary density. Reactive hyp eremia, LDF pattern and tcpO(2) did not differ significantly. Microcirculat ory examinations did not yield additional information to clinical and Doppl er sonographic results. Conclusion: In clinical practice, the role of microcirculation evaluation t echniques for diabetic foot syndrome is limited.