TEAM-APPROACH TOWARD LOWER-EXTREMITY AMPUTATION PREVENTION IN DIABETES

Through a discussion of the etiology and pathology of diabetic foot le sions with particular emphasis on ulceration and osteoarthropathy, the author will develop a plan for treatment and prevention using a multi disciplinary approach to such problems. Underlying risk factors includ ing neuropathy, ischemia, infection, and, especially high pressures mu st be evaluated and appropriately ameliorated in order to promote reso lution and avoidance of recidivism. Accordingly, conservative manageme nt with pressure-relieving devices, topical therapies, and prophylacti c surgery on structural deformities plays an integral part in the over all pediatric management of the high-risk foot in diabetes mellitus.