Abstract
Recently, the cause of lower limb amputation is changing remarkably and the number of amputation due to diabetic foot disorder is increasing in Japan. Diabetic foot disorder is characterized by a complex triad of diabetic neuropathy, ischemia, and infection. Especially, critical limb ischemia complicated by diabetes mellitus is a primary cause by lower limb amputation. For this diabetic foot disorders, different approaches to dealing with various problems (such as paralysis and toe deformity due to diabetic peripheral neuropathy, ischemic symptom due to peripheral artery disease, and inflammation of the bone marrow) are required. In addition, multidisciplinary approach that spans not only single- department but also multi-departments and multi-occupations is desired because these clinical conditions can range from mild to severe. When the optimal team approach is considered, it is useful to classify foot management according to severity from primary to tertiary care. It is also necessary to provide prompt and best medical care through a smooth regional partnership in order that patients are not concentrated in one medical center. In this paper, we sum up the current status of team approach to diabetic limb salvage and describe the outlook for future problem.
